Provider Demographics
NPI:1053332718
Name:BLOCK, BARBARA RAE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:RAE
Last Name:BLOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 COLUMBUS AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1382
Mailing Address - Country:US
Mailing Address - Phone:914-773-1851
Mailing Address - Fax:914-769-3156
Practice Address - Street 1:420 COLUMBUS AVE STE 308
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1382
Practice Address - Country:US
Practice Address - Phone:914-773-1851
Practice Address - Fax:914-769-3156
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0436961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
134074215OtherFEDERAL TAX ID