Provider Demographics
NPI:1780075804
Name:BARRY, JULIE M (LMFT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:BARRY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1459 WOODLAWN RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-9381
Mailing Address - Country:US
Mailing Address - Phone:502-257-6290
Mailing Address - Fax:844-684-3397
Practice Address - Street 1:310 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1026
Practice Address - Country:US
Practice Address - Phone:502-257-6290
Practice Address - Fax:844-684-3397
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY168387106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100428320Medicaid