Provider Demographics
NPI:1174585202
Name:LAYTON, BARRY S (PHD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:S
Last Name:LAYTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 GREEN RD STE 218
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5719
Mailing Address - Country:US
Mailing Address - Phone:216-595-8900
Mailing Address - Fax:216-595-0088
Practice Address - Street 1:3601 GREEN RD STE 218
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5719
Practice Address - Country:US
Practice Address - Phone:216-595-8900
Practice Address - Fax:216-595-0088
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3804103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0678557Medicaid
OHCP14592Medicare PIN