Provider Demographics
NPI:1184658965
Name:KLEIN, BARRY LEONARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:LEONARD
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:BARRY
Other - Middle Name:LEONARD
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 720535
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3325 PADDOCKS PKWY STE 415
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6059
Practice Address - Country:US
Practice Address - Phone:404-216-0336
Practice Address - Fax:678-513-1188
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001010103T00000X
GAPSY001010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OTH00Medicare UPIN
GA$$$$$$$$$AMedicare PIN