Provider Demographics
NPI:1972644102
Name:BARRETT, CHRISTINA HAMILTON (GSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:HAMILTON
Last Name:BARRETT
Suffix:
Gender:F
Credentials:GSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-0156
Mailing Address - Country:US
Mailing Address - Phone:225-936-1923
Mailing Address - Fax:
Practice Address - Street 1:12126 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:LA
Practice Address - Zip Code:70722-3017
Practice Address - Country:US
Practice Address - Phone:225-683-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA92971041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA9297OtherGSW CERTIFICATION