Provider Demographics
NPI:1811916018
Name:BEAR, BARBARA M (PSYD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:BEAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8834
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27419-0834
Mailing Address - Country:US
Mailing Address - Phone:336-545-9696
Mailing Address - Fax:336-852-2595
Practice Address - Street 1:5509B W FRIENDLY AVE STE 203
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4279
Practice Address - Country:US
Practice Address - Phone:336-545-9696
Practice Address - Fax:336-852-2595
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2848103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000606Medicaid
NC6000606Medicaid