Provider Demographics
NPI:1750421848
Name:GREENLEE, BARRY ANTHONY (LMFT)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:ANTHONY
Last Name:GREENLEE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 US HIGHWAY 51 BYP N
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-2872
Mailing Address - Country:US
Mailing Address - Phone:731-288-4606
Mailing Address - Fax:731-288-4650
Practice Address - Street 1:1865 US HIGHWAY 51 BYP N
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2872
Practice Address - Country:US
Practice Address - Phone:731-288-4606
Practice Address - Fax:731-288-4650
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLMT0000000572106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist