Provider Demographics
NPI:1285056390
Name:MCVAY, BARRY WILLIAM (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:WILLIAM
Last Name:MCVAY
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28558 SW WAGNER ST
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-6786
Mailing Address - Country:US
Mailing Address - Phone:503-753-9863
Mailing Address - Fax:
Practice Address - Street 1:28558 SW WAGNER ST
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-6786
Practice Address - Country:US
Practice Address - Phone:503-753-9863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3143101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health