Provider Demographics
NPI:1780149468
Name:BARKIN, STACY
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:
Last Name:BARKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 N 83RD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7302
Mailing Address - Country:US
Mailing Address - Phone:619-994-2237
Mailing Address - Fax:480-947-2428
Practice Address - Street 1:2600 E SOUTHERN AVE STE E1
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7744
Practice Address - Country:US
Practice Address - Phone:480-409-0322
Practice Address - Fax:877-559-2816
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-11684101YA0400X
AZLPC-13173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)