=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417832346
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BARBARA BEAR, PSY.D., PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2025
-----------------------------------------------------
Last Update Date | 08/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5509B W FRIENDLY AVE STE 203
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27410-4279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-545-9696
-----------------------------------------------------
Fax | 336-464-2750
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5509B W FRIENDLY AVE STE 203
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27410-4279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-545-9696
-----------------------------------------------------
Fax | 336-464-2750
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BARBARA MANNING BEAR
-----------------------------------------------------
Credential | PSYD
-----------------------------------------------------
Telephone | 336-404-5969
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------