Provider Demographics
NPI:1427078302
Name:BARRY, CHRISTINE T (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:T
Last Name:BARRY
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7700
Practice Address - Fax:216-286-6341
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4596103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10158570000001OtherPA MEDICAID
OH5073157OtherAETNA
OH000000028114OtherANTHEM
OH221143OtherUNISON
OH0917833OtherBCMH
OH000000525877OtherANTHEM
OHP00412273OtherRAILROAD MEDICARE
OH0917833Medicaid
OH363342OtherWELLCARE
OH221143OtherUNISON
OHP00412273OtherRAILROAD MEDICARE
OHBACP31372Medicare PIN