Provider Demographics
NPI:1912455254
Name:BARRETO, DAVID (LCPC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BARRETO
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 S LINCOLN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-4290
Mailing Address - Country:US
Mailing Address - Phone:630-277-9608
Mailing Address - Fax:
Practice Address - Street 1:143 S LINCOLN AVE STE C
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-4290
Practice Address - Country:US
Practice Address - Phone:630-277-9608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL85-0717906OtherGROUP TIN