Provider Demographics
NPI:1003504655
Name:BARKER BEHAVIOR THERAPY
Entity Type:Organization
Organization Name:BARKER BEHAVIOR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:606-922-8857
Mailing Address - Street 1:9371 W LA SALLE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2964
Mailing Address - Country:US
Mailing Address - Phone:606-922-8857
Mailing Address - Fax:303-845-9102
Practice Address - Street 1:9371 W LA SALLE AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2964
Practice Address - Country:US
Practice Address - Phone:606-922-8857
Practice Address - Fax:303-845-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty