Provider Demographics
NPI:1902427537
Name:BARCLAY, ELAINE MARIE
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:MARIE
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ELAINE
Other - Middle Name:MARIE
Other - Last Name:BARCLAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, NBCC, THTC
Mailing Address - Street 1:3209 REAGENEA DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8197
Mailing Address - Country:US
Mailing Address - Phone:214-307-1925
Mailing Address - Fax:888-284-2669
Practice Address - Street 1:809 WOODBRIDGE PKWY STE 500-131
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-7148
Practice Address - Country:US
Practice Address - Phone:214-307-1925
Practice Address - Fax:888-284-2669
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009221101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health