Provider Demographics
NPI:1154668382
Name:BARRETT, MICHELLE IVY GREENSPOON (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:IVY GREENSPOON
Last Name:BARRETT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:IVY
Other - Last Name:GREENSPOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:8516 BELL GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3183
Mailing Address - Country:US
Mailing Address - Phone:805-252-9305
Mailing Address - Fax:
Practice Address - Street 1:300 VEAZEY DR
Practice Address - Street 2:
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-1668
Practice Address - Country:US
Practice Address - Phone:919-764-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NC5501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health