Active NPI
Declan T Barry, M.D.
- Counseling Psychologist
- New Haven, CT
National Provider Identifier
1679906911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 2552
- Practice address
- 495 Congress Ave
New Haven, CT 06519-1312 - Phone
- (203) 781-4600
- Fax
- (203) 781-4624
- NPI assigned
- Aug 9, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 2552 | CT | Primary |
Addresses
Primary practice location
495 Congress Ave
New Haven, CT 06519-1312
Mailing address
1 Long Wharf Dr
New Haven, CT 06511-5991
Phone (203) 781-4600
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004041000 | Medicaid | CT | |
| 004082260 | Medicaid | CT | |
| 004082286 | Medicaid | CT | |
| 008022626 | Medicaid | CT | |
| 008048393 | Medicaid | CT | |
| 008003745 | Medicaid | CT | |
| 008022622 | Medicaid | CT | |
| 008001325 | Medicaid | CT | |
| 500000315 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642982400000",
"number": "1679906911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115991",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 CONGRESS AVE",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065191312",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARRY",
"first_name": "DECLAN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-09",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CT",
"license": "2552",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004041000",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004082260",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004082286",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008022626",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008048393",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008003745",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008022622",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008001325",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500000315",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.