Provider Demographics
NPI:1730692435
Name:BARRETT, EMILY J (LPCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 NORTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3441
Mailing Address - Country:US
Mailing Address - Phone:216-212-2069
Mailing Address - Fax:
Practice Address - Street 1:246 NORTHLAND DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3441
Practice Address - Country:US
Practice Address - Phone:216-212-2069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700234101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1356601892Medicaid