Provider Demographics
NPI:1124636030
Name:BARCLAY, RYAN ANDREW (LPC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ANDREW
Last Name:BARCLAY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1934 E CAMELBACK RD # 120-513
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4126
Mailing Address - Country:US
Mailing Address - Phone:602-638-1658
Mailing Address - Fax:
Practice Address - Street 1:1934 E CAMELBACK RD # 120-513
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4126
Practice Address - Country:US
Practice Address - Phone:602-638-1658
Practice Address - Fax:602-462-8737
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC10342101YM0800X
AZLPC-19411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ084043Medicaid