Provider Demographics
NPI:1639456049
Name:BARRETT, BEVIN COLLEEN SHIELDS (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:BEVIN
Middle Name:COLLEEN SHIELDS
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270961
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77277-0961
Mailing Address - Country:US
Mailing Address - Phone:832-434-7114
Mailing Address - Fax:
Practice Address - Street 1:5119 SKINNER LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-8125
Practice Address - Country:US
Practice Address - Phone:832-434-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional