Barry Brody PHD LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

MT983 Issued in FL

Legal business name

BARRY BRODY PHD LLC

Doing business as

Dr. Brody LLC

Practice address

871 SW State Road 47
Lake City, FL 32025-0433

Phone

(386) 755-1720

Fax

(386) 754-1325

NPI assigned

Jan 1, 2015

Last updated

Sep 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barry Brody, PH.D.NPI 1376638775

Title

Manager-Member

Phone

(386) 755-1720

Specialties & licenses 2

Addresses

Other names 1

• Dr. Brody LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barry Brody, PH.D.

  • Marriage & Family Therapist
  • Lake City, FL
  • NPI 1376638775
  NPD Authorized official

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

{
    "created_epoch": "1420070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1780072512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 SW STATE ROAD 47",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250433",
            "telephone_number": "386-755-1720",
            "fax_number": "386-754-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 SW STATE ROAD 47",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250433",
            "telephone_number": "386-755-1720",
            "fax_number": "386-754-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY BRODY PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-01",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "BRODY",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "MANAGER-MEMBER",
        "authorized_official_telephone_number": "386-755-1720",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "MT983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Brody LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Barlow
• Michele Barnes
• Starsha Monet Barnes
• Jay Alan Baron
• Courtney Nicole Barraza
• Harold Van Barry II
• Kelley Barton
• Rebekah Mae Bass
• Brenda J Bates, CRDH
• Dylan Batlle, DMD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Lake City, FL
• Providers in Lake City, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.