Provider Demographics
NPI:1679508527
Name:BARRETT, PAMELIA J A (MSW,LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELIA
Middle Name:J A
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MSW,LCSW
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 26
Mailing Address - Street 2:
Mailing Address - City:BUXTON
Mailing Address - State:ME
Mailing Address - Zip Code:04093-0026
Mailing Address - Country:US
Mailing Address - Phone:207-727-4411
Mailing Address - Fax:207-727-4342
Practice Address - Street 1:11 RIVER RD
Practice Address - Street 2:
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093
Practice Address - Country:US
Practice Address - Phone:207-727-4411
Practice Address - Fax:207-727-4342
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME1515861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME033863OtherBC/BS STAR
ME332394OtherMAGELLAN BEHAVIORAL HEALT
ME5816742OtherAETNA BEHAVIORAL HEALTH
MEMM7125Medicare ID - Type UnspecifiedMEDICARE