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General NPI Number Information
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NPI Number | 1275374381
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Entity Type | Individual
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Provider Name | BARRY JAY MCCLINTOCK PLPC
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Gender | Male
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 8949 MANCHESTER RD
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City | BRENTWOOD
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State | MO
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Zip | 63144-2621
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Country | US
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Telephone | 314-329-4326
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Fax |
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Provider Business Mailing Address
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Address Line | 2565 CIRCLE DR
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City | MAPLEWOOD
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State | MO
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Zip | 63143-1704
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Country | US
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Telephone | 314-315-7838
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Fax |
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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 | 2022042469
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License Number State | MO
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