Basic Information
Provider Information
NPI: 1982744751
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRETT
FirstName: ANDREA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 446 METROPLEX DR
Address2: SUITE A-100
City: NASHVILLE
State: TN
PostalCode: 372113139
CountryCode: US
TelephoneNumber: 6157810013
FaxNumber: 6157810688
Practice Location
Address1: 446 METROPLEX DR
Address2: SUITE A-100
City: NASHVILLE
State: TN
PostalCode: 372113139
CountryCode: US
TelephoneNumber: 6157810013
FaxNumber: 6157810688
Other Information
ProviderEnumerationDate: 02/08/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X2040TNY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


Home