Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 011141 | NY |
Y | 103T00000X | Psychologist | 011141 | NY |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 011141 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 011141 | NY |
N | 103G00000X | Clinical Psychologist | 011141 | NY |
N | 103TC0700X | Clinical Psychologist | 011141 | NY |
NPI | 1235163130 |
---|---|
Provider Name | Dr. Thomas J Barkley |
First Address | Saratoga Springs, NY 12866-6076 |
Second Address | Saratoga Springs, NY 12866-6076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 20/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
011141 | LICENSE NUMBER (01) | NY |
10022509 | CDPHP HMO PIN (01) | NY |
131773 | VO MCO PIN (01) | NY |
41386 | MVP HMO PIN (01) | NY |
6894248 | GHI MCO PIN (01) | NY |