Organization
BARRETT ENTERPRISE
Active
Organization
BARRETT ENTERPRISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH ANTHONY BARRETT MSW, LCSW (THERAPIST)
(636) 206-2650
Entity
Organization
Contact information
Practice address
801 WOODLAWN AVE, O FALLON, MO 63366-7646
(636) 206-2650
Mailing address
714 CROMPTON CT, SAINT LOUIS, MO 63126-1255
(314) 584-9754
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609059468
CAQH
MO
Enumeration date
04/15/2018
Last updated
04/15/2018
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