Provider Demographics
NPI:1265550479
Name:BARRITT, THOMAS M (LICSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:M
Last Name:BARRITT
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 TALCOTT RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-2089
Mailing Address - Country:US
Mailing Address - Phone:802-876-1100
Mailing Address - Fax:802-876-1101
Practice Address - Street 1:183 TALCOTT RD
Practice Address - Street 2:SUITE 206
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-2089
Practice Address - Country:US
Practice Address - Phone:802-876-1100
Practice Address - Fax:802-876-1101
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00000121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN 2203Medicaid