Provider Demographics
NPI:1548443229
Name:BARRY, TIMOTHY PATRICK (LCSW)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:PATRICK
Last Name:BARRY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SAN FRANCISCO GENERAL HOSPITAL OTOP
Mailing Address - Street 2:1001 POTRERO AVENUE, WARD 93 BOX 0852
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CALIFORNIA
Mailing Address - Zip Code:94110
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVENUE, WARD 93, BUILDING 90, 3RD FLOOR
Practice Address - Street 2:SAN FRANCISCO GENERAL HOSPITAL OTOP
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-206-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1155321041C0700X
CA254491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical