Provider Demographics
NPI:1669418448
Name:RAND, BARRY E (PHD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:E
Last Name:RAND
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 1:126 CHURCHILL DOWNS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-9763
Mailing Address - Country:US
Mailing Address - Phone:828-216-0018
Mailing Address - Fax:
Practice Address - Street 1:1 ZILLICOA ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1049
Practice Address - Country:US
Practice Address - Phone:828-216-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2536103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000010Medicaid
NC2492720Medicare ID - Type UnspecifiedLICENSED PSYCHOLOGIST