Provider Demographics
NPI:1043806805
Name:BARRY, JAMES ALAN JR (LICSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALAN
Last Name:BARRY
Suffix:JR
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 DUGGAN LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01073-9499
Mailing Address - Country:US
Mailing Address - Phone:860-550-3157
Mailing Address - Fax:
Practice Address - Street 1:19 DUGGAN LN
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01073-9499
Practice Address - Country:US
Practice Address - Phone:860-550-3157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0002263241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical