Healthcare Provider Details

I. General information

NPI: 1578720199
Provider Name (Legal Business Name): SANDY BARKLEY M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MAIN ST SUITE 305
KLAMATH FALLS OR
97601-6049
US

IV. Provider business mailing address

501 MAIN ST SUITE 305
KLAMATH FALLS OR
97601-6049
US

V. Phone/Fax

Practice location:
  • Phone: 541-273-0709
  • Fax:
Mailing address:
  • Phone: 541-273-0709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC1534
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC36175
License Number StateCA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: