Provider Demographics
NPI:1992729479
Name:LINDEN, BARRY W (PHD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:W
Last Name:LINDEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 W THUNDERBIRD RD
Mailing Address - Street 2:STE 309
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4710
Mailing Address - Country:US
Mailing Address - Phone:602-938-3323
Mailing Address - Fax:602-938-1626
Practice Address - Street 1:5310 W THUNDERBIRD RD
Practice Address - Street 2:STE 309
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4710
Practice Address - Country:US
Practice Address - Phone:602-938-3323
Practice Address - Fax:602-938-1626
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1715103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPHD1715CMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
AZR09460Medicare UPIN