Provider Demographics
NPI:1073579215
Name:BARCLAY, JANICE KAY (L P C)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:KAY
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:L P C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 NORTH SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-6647
Mailing Address - Country:US
Mailing Address - Phone:479-986-0566
Mailing Address - Fax:479-986-0599
Practice Address - Street 1:324 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-6647
Practice Address - Country:US
Practice Address - Phone:479-986-0566
Practice Address - Fax:479-986-0599
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0003010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X200Medicare ID - Type Unspecified