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General NPI Number Information
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NPI Number | 1124349436
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Entity Type | Individual
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Provider Name | DAVID MICHAEL BARRY L.M.H.C
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Gender | Male
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 3 HAVILAND ST
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City | WORCESTER
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State | MA
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Zip | 01602-2108
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Country | US
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Telephone | 508-847-9605
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Fax | 888-505-1589
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Provider Business Mailing Address
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Address Line | 210 PARK AVE # 358
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City | WORCESTER
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State | MA
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Zip | 01609-2246
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Country | US
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Telephone | 508-847-9605
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Fax | 888-505-1596
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4336
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License Number State | MA
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