Provider Demographics
NPI:1134255961
Name:BARRETT, ELIZABETH W (MFT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:W
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-2218
Mailing Address - Country:US
Mailing Address - Phone:805-481-1955
Mailing Address - Fax:
Practice Address - Street 1:1720 BISHOP ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4691
Practice Address - Country:US
Practice Address - Phone:805-544-0801
Practice Address - Fax:805-544-2611
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40518106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist