Provider Demographics
NPI:1811553720
Name:BARCLAY, CHRISTOPHER MICHAEL (BCBA, NCSP)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:BARCLAY
Suffix:
Gender:M
Credentials:BCBA, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BIRCH TRL
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4039
Mailing Address - Country:US
Mailing Address - Phone:770-468-0245
Mailing Address - Fax:
Practice Address - Street 1:121 BIRCH TRL
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4039
Practice Address - Country:US
Practice Address - Phone:860-365-2774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT560103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst