Provider Demographics
NPI:1962709931
Name:COY, BARRY C (MED, LCPC)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:C
Last Name:COY
Suffix:
Gender:M
Credentials:MED, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3089
Mailing Address - Street 2:CENTER FOR MENTAL HEALTH
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-265-9639
Mailing Address - Fax:406-265-6771
Practice Address - Street 1:312 3RD ST # 1658
Practice Address - Street 2:CENTER FOR MENTAL HEALTH
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3534
Practice Address - Country:US
Practice Address - Phone:406-265-9639
Practice Address - Fax:406-265-6771
Is Sole Proprietor?:No
Enumeration Date:2011-02-27
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000747930OtherBLUE CROSS-SHIELD OF MONTANA