Provider Demographics
NPI:1790433779
Name:BARBERA, KRISTA LYNN (JD, PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:LYNN
Last Name:BARBERA
Suffix:
Gender:F
Credentials:JD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 BEASLEY NECK RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-9325
Mailing Address - Country:US
Mailing Address - Phone:856-935-4634
Mailing Address - Fax:
Practice Address - Street 1:374 BEASLEY NECK RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-9325
Practice Address - Country:US
Practice Address - Phone:856-935-4634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00647900103TC0700X, 103T00000X
103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic