Provider Demographics
NPI:1497341853
Name:BARCLAY, ELIZABETH (LPC, LICDC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:LPC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 W ALEX BELL RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-1243
Mailing Address - Country:US
Mailing Address - Phone:704-277-6864
Mailing Address - Fax:
Practice Address - Street 1:8063 WASHINGTON VILLAGE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1847
Practice Address - Country:US
Practice Address - Phone:937-294-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2405702101Y00000X, 101Y00000X
OHLICDC.162581101YA0400X
OH179610101YA0400X
OHLCDCII.161940101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)