Provider Demographics
NPI:1801880877
Name:OBLAS, BARRY (MSW)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:OBLAS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13838 S 46TH PL
Mailing Address - Street 2:STE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-7801
Mailing Address - Country:US
Mailing Address - Phone:602-469-0899
Mailing Address - Fax:480-283-0831
Practice Address - Street 1:13838 S 46TH PL
Practice Address - Street 2:STE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-7801
Practice Address - Country:US
Practice Address - Phone:602-460-9800
Practice Address - Fax:480-705-8848
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW2978101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health