Provider Demographics
NPI:1487697397
Name:BARNETT, RICHARD LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:BARNETT
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 1:25700 SCIENCE PARK DRIVE. SUITE 200
Mailing Address - Street 2:LARNDMARK CENTRE.
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-831-1040
Mailing Address - Fax:216-831-2667
Practice Address - Street 1:3884 WOODTHRUSH RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-1527
Practice Address - Country:US
Practice Address - Phone:330-670-8511
Practice Address - Fax:330-665-3142
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4274103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH680002183OtherRAILROAD MEDICARE
OH0792058Medicaid
OH680002183OtherRAILROAD MEDICARE
OHBAC09281Medicare ID - Type Unspecified