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NPI Code Detail

MEDICARE: CAROL Z BARRY LCP

MEDICARE: CAROL Z BARRY LCP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistLCP #015KS

General Provider Information

NPI Number : 1043369770
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL Z BARRY LCP
Provider Business Mailing Address
First Line : 7840 WASHINGTON AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112-2152
Country : US
Telephone Number : 913-328-4816
Fax Number :
Provider Business Practice Location Address
First Line : 7840 WASHINGTON AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112-2152
Country : US
Telephone Number : 913-328-4816
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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