Provider Demographics
NPI:1992256077
Name:BARRETT, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SAINT JOHN ST APT 2R
Mailing Address - Street 2:APT 2
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2517
Mailing Address - Country:US
Mailing Address - Phone:727-515-2201
Mailing Address - Fax:
Practice Address - Street 1:485 NANTASKET AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HULL
Practice Address - State:MA
Practice Address - Zip Code:02045-2556
Practice Address - Country:US
Practice Address - Phone:781-925-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health