Provider Demographics
NPI:1174643704
Name:MCFALL, BARRETTE WELCH (MS, CRC, LCAS, LPC)
Entity type:Individual
Prefix:
First Name:BARRETTE
Middle Name:WELCH
Last Name:MCFALL
Suffix:
Gender:F
Credentials:MS, CRC, LCAS, LPC
Other - Prefix:
Other - First Name:BARRETTE
Other - Middle Name:QUINN
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3705 SAINT MARKS RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5010
Mailing Address - Country:US
Mailing Address - Phone:919-606-7537
Mailing Address - Fax:
Practice Address - Street 1:3705 SAINT MARKS RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5010
Practice Address - Country:US
Practice Address - Phone:919-606-7537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1129101YA0400X
NC7026101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6111933Medicaid