Provider Demographics
NPI:1043548902
Name:BARCLAY, LAWRENCE DEMETRIUS (MS)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:DEMETRIUS
Last Name:BARCLAY
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5108 MCCLELLAN BLVD
Mailing Address - Street 2:APT 129
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36206-1874
Mailing Address - Country:US
Mailing Address - Phone:245-322-0373
Mailing Address - Fax:
Practice Address - Street 1:901 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1106
Practice Address - Country:US
Practice Address - Phone:256-492-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6930784101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health