Provider Demographics
NPI:1013415819
Name:BARR PRACTICE LCSW PLLC
Entity Type:Organization
Organization Name:BARR PRACTICE LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHATINA
Authorized Official - Middle Name:CHEREE
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:716-812-0472
Mailing Address - Street 1:15 LASALLE AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2641
Mailing Address - Country:US
Mailing Address - Phone:716-812-0472
Mailing Address - Fax:716-939-2108
Practice Address - Street 1:15 LASALLE AVE STE 107
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-2641
Practice Address - Country:US
Practice Address - Phone:716-812-0472
Practice Address - Fax:716-939-2108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0847061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty