Provider Demographics
NPI:1013089051
Name:BARRATT, MARILOU (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MARILOU
Middle Name:
Last Name:BARRATT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10060 VISTA CT
Mailing Address - Street 2:
Mailing Address - City:MYERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21773-8138
Mailing Address - Country:US
Mailing Address - Phone:240-818-8344
Mailing Address - Fax:
Practice Address - Street 1:10060 VISTA CT
Practice Address - Street 2:
Practice Address - City:MYERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21773-8138
Practice Address - Country:US
Practice Address - Phone:240-818-8344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD041111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA010010391OtherINTEGRATED BEHAVIORAL HEA
MDQR55MOtherCAREFIRST BCBS OF MD
MDR5440001OtherCAREFIRST BCBS-FED EMPLOY
MD4223346OtherAETNA ID #
MDQR55OtherMAGELLAN
MD17707OtherCIGNA
MD181602YAZGOtherIND. PTAN
MD183417OtherINC PTAN
MDR5440001OtherCAREFIRST BLUE CHOICE
MD324025OtherMAMSI, ALLLIANCE, OPTIMUM
MI002258OtherVALUEOPTIONS
MDPVPB122176OtherAM PSYCH SERVICES
MDQR55Medicare ID - Type Unspecified
MDPVPB122176OtherAM PSYCH SERVICES