Provider Demographics
NPI:1053336370
Name:BARR, THOMAS J (PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:BARR
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 1:304 SANDY LN
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-6190
Mailing Address - Country:US
Mailing Address - Phone:303-664-5281
Mailing Address - Fax:
Practice Address - Street 1:1770 25TH AVE
Practice Address - Street 2:STE 206
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4949
Practice Address - Country:US
Practice Address - Phone:303-664-5281
Practice Address - Fax:800-854-6944
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2160103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R04236Medicare UPIN
COCO305852Medicare PIN
C805948Medicare PIN