Provider Demographics
NPI:1821149386
Name:BARRY, TERESA A (LPC, NCC, RN)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:A
Last Name:BARRY
Suffix:
Gender:F
Credentials:LPC, NCC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-1702
Mailing Address - Country:US
Mailing Address - Phone:570-994-9606
Mailing Address - Fax:
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-2816
Practice Address - Country:US
Practice Address - Phone:570-426-7150
Practice Address - Fax:570-426-9484
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2014-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002949101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional