Ethan M. Barrett, LCDP

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Providence, RI

NPI 1942546403 · NPPES record last updated Jan 2, 2013

Key facts

NPI
1942546403
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CDP00541 (RI)
Practice address
530 N Main St
Providence, RI 02904-5762
Phone
(401) 274-2500
NPI assigned
Jan 2, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CDP00541RIMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDP00541 RI Yes

Addresses

Primary practice location

530 N Main St
Providence, RI 02904-5762

Mailing address

528 N Main St
Providence, RI 02904-5757

Other providers in Providence, RI

All providers in Providence, RI · Addiction (Substance Use Disorder) Counselor in Rhode Island

Sources for this page

Verify at the official NPI Registry.