Healthcare Provider Details

I. General information

NPI: 1235163130
Provider Name (Legal Business Name): THOMAS J BARKLEY PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 WEST AVE SUITE 207
SARATOGA SPRINGS NY
12866-6076
US

IV. Provider business mailing address

120 WEST AVE SUITE 207
SARATOGA SPRINGS NY
12866-6076
US

V. Phone/Fax

Practice location:
  • Phone: 518-584-8051
  • Fax: 518-584-2523
Mailing address:
  • Phone: 518-584-8051
  • Fax: 518-584-2523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number011141
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number011141
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number011141
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number011141
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: