Clifford Timothy Barry, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401001261 Issued in MI

Practice address

777 Goguac St W Ste B2
Springfield, MI 49015-2097

Phone

(269) 223-7786

NPI assigned

Jan 21, 2016

Last updated

Apr 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Functional Kids Therapy Center LLC

  dba Functional Kids

  • Pediatric Occupational Therapist
  • Springfield, MI
  • NPI 1578951380
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1740647718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8653 N 32ND ST STE 1A",
            "city": "RICHLAND",
            "state": "MI",
            "postal_code": "490839494",
            "telephone_number": "269-967-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GOGUAC ST W STE B2",
            "city": "SPRINGFIELD",
            "state": "MI",
            "postal_code": "490152097",
            "telephone_number": "269-223-7786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8653 N 32nd St Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "MI",
            "postal_code": "490839494",
            "country_code": "US",
            "telephone_number": "269-967-8144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRY",
        "first_name": "CLIFFORD",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-21",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401001261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adl Rehabilitation
• Cailin Alivia Amundsen, CCC-SLP
• Elana Maire Baiocchi, LLPC
• Aaron Matthew Begley, TLLP
• Danielle E Brabant, M.A. CCC-SLP
• Care Commuity
• Care Community
• Talona Sue Carpenter-Schultz, N.P.

• Professional Counselor in Springfield, MI
• Providers in Springfield, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.