Provider Demographics
NPI:1902929862
Name:BARRETT, NICOLE JOSEFINA (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:JOSEFINA
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:JOSEFINA
Other - Last Name:STAEHELI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-899-5200
Mailing Address - Fax:425-899-5204
Practice Address - Street 1:1200 112TH AVE NE STE C160
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3742
Practice Address - Country:US
Practice Address - Phone:425-339-5453
Practice Address - Fax:425-453-8955
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW600847871041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical