Provider Demographics
NPI:1215971536
Name:BARRIOS, ANNELI SYLVIA (PHD)
Entity type:Individual
Prefix:
First Name:ANNELI
Middle Name:SYLVIA
Last Name:BARRIOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5137 PERFECTION LN
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-7547
Mailing Address - Country:US
Mailing Address - Phone:800-608-0371
Mailing Address - Fax:800-608-9427
Practice Address - Street 1:114 N MAIN ST STE 102B
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434
Practice Address - Country:US
Practice Address - Phone:800-608-0371
Practice Address - Fax:800-608-9427
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004561103TC0700X
NY016141103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02711237Medicaid