Provider Demographics
NPI:1306646195
Name:BARRY, ANDREA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:BARRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1519 SAN ANTONE LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2855
Mailing Address - Country:US
Mailing Address - Phone:214-537-3467
Mailing Address - Fax:
Practice Address - Street 1:1650 W CHAPMAN DR STE 500
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266-8302
Practice Address - Country:US
Practice Address - Phone:972-836-9249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX586091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty