Provider Demographics
NPI:1720191851
Name:BARCLAY, BEVERLY J (PHD)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:J
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:J
Other - Last Name:COMBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1489 W WARM SPRINGS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7367
Mailing Address - Country:US
Mailing Address - Phone:805-746-2691
Mailing Address - Fax:
Practice Address - Street 1:1489 W WARM SPRINGS RD STE 110239
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7635
Practice Address - Country:US
Practice Address - Phone:805-746-2691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6406101YA0400X
COPSY 3159103TC0700X
CAPSY22258103TC0700X
CO4387101YP2500X
NVPY0960103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist