Healthcare Provider Details

I. General information

NPI: 1720191851
Provider Name (Legal Business Name): BEVERLY J BARCLAY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEVERLY J COMBS

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 W WARM SPRINGS RD STE 110239
HENDERSON NV
89014-7635
US

IV. Provider business mailing address

1489 W WARM SPRINGS RD STE 110
HENDERSON NV
89014-7367
US

V. Phone/Fax

Practice location:
  • Phone: 805-746-2691
  • Fax:
Mailing address:
  • Phone: 805-746-2691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6406
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4387
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY0960
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY22258
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY0960
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 3159
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: