Provider Demographics
NPI:1932816121
Name:BARRETT, KELSEY RAE
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:RAE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LYNN CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:IN
Mailing Address - Zip Code:46167-8952
Mailing Address - Country:US
Mailing Address - Phone:317-442-5603
Mailing Address - Fax:
Practice Address - Street 1:20 LYNN CT
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:IN
Practice Address - Zip Code:46167-8952
Practice Address - Country:US
Practice Address - Phone:317-442-5603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker