Provider Demographics
NPI:1124349436
Name:BARRY, DAVID MICHAEL (LMHC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MICHAEL
Last Name:BARRY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 PARK AVE # 358
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2246
Mailing Address - Country:US
Mailing Address - Phone:508-847-9605
Mailing Address - Fax:888-505-1596
Practice Address - Street 1:3 HAVILAND ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-2108
Practice Address - Country:US
Practice Address - Phone:508-847-9605
Practice Address - Fax:888-505-1589
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health