Provider Demographics
NPI:1790462026
Name:BARRETT, MONIQUE ZAVON
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ZAVON
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 THATFORD AVE APT 8C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-5978
Mailing Address - Country:US
Mailing Address - Phone:929-215-4066
Mailing Address - Fax:
Practice Address - Street 1:345 THATFORD AVE APT 8C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-5978
Practice Address - Country:US
Practice Address - Phone:929-215-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013629101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health