Provider Demographics
NPI:1740606037
Name:BARCLAY, SHIRLEY (LCSW)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SW
Mailing Address - Street 1:130 S INDIAN RIVER DR STE 202
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4353
Mailing Address - Country:US
Mailing Address - Phone:772-773-0229
Mailing Address - Fax:772-772-8600
Practice Address - Street 1:130 S INDIAN RIVER DR STE 202
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4353
Practice Address - Country:US
Practice Address - Phone:772-773-0229
Practice Address - Fax:772-272-8600
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL51241041C0700X
FLSW5124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical