Provider Demographics
NPI:1790375798
Name:REBECCA BARRETT PLLC
Entity type:Organization
Organization Name:REBECCA BARRETT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LMHC
Authorized Official - Phone:360-301-8033
Mailing Address - Street 1:17503 25TH AVE NE UNIT P302
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271-4847
Mailing Address - Country:US
Mailing Address - Phone:360-301-8033
Mailing Address - Fax:
Practice Address - Street 1:17503 25TH AVE NE UNIT P302
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-4847
Practice Address - Country:US
Practice Address - Phone:360-301-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1831706241Medicaid