Provider Demographics
NPI:1306890991
Name:BARRETT, RICHARD H II (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:H
Last Name:BARRETT
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 N 34TH ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-0352
Mailing Address - Country:US
Mailing Address - Phone:479-561-3144
Mailing Address - Fax:866-988-3317
Practice Address - Street 1:211 N 34TH ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-0352
Practice Address - Country:US
Practice Address - Phone:479-561-3144
Practice Address - Fax:866-988-3317
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9713P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR327997Medicare PIN