Basic Information
Provider Information
NPI: 1154668382
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRETT
FirstName: MICHELLE
MiddleName: GREENSPOON
NamePrefix: MRS.
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GREENSPOON
OtherFirstName: MICHELLE
OtherMiddleName: IVY
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: MA
OtherLastNameType: 1
Mailing Information
Address1: 2034 DE LA VINA ST
Address2:  
City: SANTA BARBARA
State: CA
PostalCode: 931053814
CountryCode: US
TelephoneNumber: 8058846850
FaxNumber:  
Practice Location
Address1: 2034 DE LA VINA ST
Address2:  
City: SANTA BARBARA
State: CA
PostalCode: 931053814
CountryCode: US
TelephoneNumber: 8058846850
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/08/2013
LastUpdateDate: 10/17/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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