Provider Demographics
NPI:1053133116
Name:BARRETT, DANYALE MELISSA
Entity type:Individual
Prefix:
First Name:DANYALE
Middle Name:MELISSA
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 240912
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-0912
Mailing Address - Country:US
Mailing Address - Phone:800-381-2309
Mailing Address - Fax:334-247-3902
Practice Address - Street 1:917 WESTERN AMERICA CIR STE 502
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-4110
Practice Address - Country:US
Practice Address - Phone:800-381-2309
Practice Address - Fax:334-247-3902
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
6814G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker