Dale Gene Barron, MA, LP, LMFT

Individual provider Active NPI Clinical Psychologist · New Brighton, MN

NPI 1366467052 · NPPES record last updated Feb 27, 2017

Key facts

NPI
1366467052
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
LP0111 (MN)
Practice address
1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone
(651) 628-9566
Fax
(651) 628-0411
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP0111MNMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0190 MN
Clinical Psychologist 103TC0700X LP0111 MN Yes

Addresses

Primary practice location

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786

Mailing address

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone (651) 628-9566

Other identifiers

IdentifierTypeStateIssuer
803248300MedicaidMN

Other providers in New Brighton, MN

All providers in New Brighton, MN · Clinical Psychologist in Minnesota

Sources for this page

Verify at the official NPI Registry.