Provider Demographics
NPI:1043766207
Name:BRIAN BARKETT, PSY.D.LLC
Entity Type:Organization
Organization Name:BRIAN BARKETT, PSY.D.LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKETT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:740-587-1543
Mailing Address - Street 1:PO BOX 621
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-0621
Mailing Address - Country:US
Mailing Address - Phone:740-587-1543
Mailing Address - Fax:740-587-1563
Practice Address - Street 1:941 RIVER RD
Practice Address - Street 2:SUITE B
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-9534
Practice Address - Country:US
Practice Address - Phone:740-587-1543
Practice Address - Fax:740-587-1573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5536103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty