Provider Demographics
NPI:1952808578
Name:BARRETT, JAMES GREGORY (LPC, CACI, SAP, PRI)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:GREGORY
Last Name:BARRETT
Suffix:
Gender:M
Credentials:LPC, CACI, SAP, PRI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GROUSE RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-7324
Mailing Address - Country:US
Mailing Address - Phone:407-473-0068
Mailing Address - Fax:
Practice Address - Street 1:5 GROUSE RIDGE WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-7324
Practice Address - Country:US
Practice Address - Phone:407-473-0068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
SC7231101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1891795738Medicaid