Provider Demographics
NPI:1780730002
Name:BARLEY PSYCHOLOGICAL SERVICES PC
Entity type:Organization
Organization Name:BARLEY PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-422-7818
Mailing Address - Street 1:155 N 1000 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-5002
Mailing Address - Country:US
Mailing Address - Phone:801-226-3178
Mailing Address - Fax:
Practice Address - Street 1:1190 N 900 E
Practice Address - Street 2:237 TLRB
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84602-3536
Practice Address - Country:US
Practice Address - Phone:801-422-7818
Practice Address - Fax:801-422-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-27
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT133172-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005734401Medicare PIN
UTS05513Medicare UPIN