Healthcare Provider Details

I. General information

NPI: 1790741502
Provider Name (Legal Business Name): BARRRY ALAN MOREIN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N MONROE ST SUITE #8
MEDIA PA
19063-3052
US

IV. Provider business mailing address

1484 QUAKER RIDGE
WEST CHESTER PA
19380-6947
US

V. Phone/Fax

Practice location:
  • Phone: 610-565-6008
  • Fax: 610-565-6008
Mailing address:
  • Phone: 610-256-1928
  • Fax: 610-565-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW012251
License Number StatePA

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: