Healthcare Provider Details

I. General information

NPI: 1457459356
Provider Name (Legal Business Name): BARRY S HENSLEY LICENSED SCHOOL PSYC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SOUTHGATE CT STE 101
HARRISONBURG VA
22801-9669
US

IV. Provider business mailing address

PO BOX 2102
HARRISONBURG VA
22801-9505
US

V. Phone/Fax

Practice location:
  • Phone: 540-434-1494
  • Fax: 540-432-9814
Mailing address:
  • Phone: 540-434-1494
  • Fax: 540-432-9814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number0803000015
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: