Provider Demographics
NPI:1861602567
Name:BARROS, MARIE E (LMFT)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:E
Last Name:BARROS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:MARIE
Other - Middle Name:E
Other - Last Name:BARROS- MEGNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:L MFT
Mailing Address - Street 1:3881 S. WESTERN AVE.
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90062
Mailing Address - Country:US
Mailing Address - Phone:323-290-4349
Mailing Address - Fax:323-293-8159
Practice Address - Street 1:3881 S. WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062
Practice Address - Country:US
Practice Address - Phone:323-290-4349
Practice Address - Fax:323-293-8159
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT77528106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQH31395OtherDEPT OF MENTAL HEALTH