Basic Information
Provider Information
NPI: 1992041966
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARKLEY
FirstName: HEITH
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1230 MONITOR ST
Address2:  
City: WENATCHEE
State: WA
PostalCode: 988013534
CountryCode: US
TelephoneNumber: 5093001221
FaxNumber: 5094237368
Practice Location
Address1: 1230 MONITOR ST
Address2:  
City: WENATCHEE
State: WA
PostalCode: 988013534
CountryCode: US
TelephoneNumber: 5093001221
FaxNumber: 5094237368
Other Information
ProviderEnumerationDate: 12/19/2012
LastUpdateDate: 08/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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