Healthcare Provider Details

I. General information

NPI: 1730825613
Provider Name (Legal Business Name): BARNYARD COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 BRAY ST
GLOUCESTER MA
01930-1555
US

IV. Provider business mailing address

42 BRAY ST
GLOUCESTER MA
01930-1555
US

V. Phone/Fax

Practice location:
  • Phone: 978-248-8800
  • Fax: 978-248-8801
Mailing address:
  • Phone: 978-248-8800
  • Fax: 978-248-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. JULIA KAY HAGGARTY
Title or Position: THERAPIST
Credential: LICSW
Phone: 978-248-8800