Provider Demographics
NPI:1700921129
Name:BARRETT, ASHLEY HENDERSON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:HENDERSON
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 STAPLES RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-1406
Mailing Address - Country:US
Mailing Address - Phone:512-393-6323
Mailing Address - Fax:512-393-6338
Practice Address - Street 1:540 STAPLES RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-1406
Practice Address - Country:US
Practice Address - Phone:512-393-6323
Practice Address - Fax:512-393-6338
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS19322171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1085771Medicaid