MEDICARE: BEVERLY J BARCLAY PH.D.

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
1	103TC0700X	Clinical Psychologist	PSY22258	CA
2	103TC0700X	Clinical Psychologist	PSY0960	NV
3	103T00000X	Psychologist	PY0960	NV
4	101YA0400X	Addiction (Substance Use Disorder) Counselor	6406	CO
5	101YP2500X	Professional Counselor	4387	CO
6	103TC0700X	Clinical Psychologist	PSY 3159	CO

General Provider Information

NPI Number	:	1720191851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY J BARCLAY PH.D.

Provider Business Mailing Address
First Line	:	1489 W WARM SPRINGS RD STE 110
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-7367
Country	:	US
Telephone Number	:	805-746-2691
Fax Number	:

Provider Business Practice Location Address
First Line	:	1489 W WARM SPRINGS RD STE 110239
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-7635
Country	:	US
Telephone Number	:	805-746-2691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	11/25/2024

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