Provider Demographics
NPI:1356812812
Name:BARKIN, SCOTT LANCE (PHD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LANCE
Last Name:BARKIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 BAY 44TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-7103
Mailing Address - Country:US
Mailing Address - Phone:718-906-5415
Mailing Address - Fax:
Practice Address - Street 1:376 BAY 44TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-7103
Practice Address - Country:US
Practice Address - Phone:718-906-5415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011395103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical