Provider Demographics
NPI:1285759530
Name:BARRETT, KAY ELIZABETH
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:ELIZABETH
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 1:1965 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-4769
Mailing Address - Country:US
Mailing Address - Phone:802-253-7338
Mailing Address - Fax:802-253-4217
Practice Address - Street 1:130 FISHER RD
Practice Address - Street 2:SUITE 1-6
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9516
Practice Address - Country:US
Practice Address - Phone:802-253-7338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT047-0000693103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT2856184OtherCIGNA
VT1007534Medicaid
VT58065OtherMAGELLAN HEALTH CARE BCBS
VT698761OtherMVP
VT1007534Medicaid