Provider Demographics
NPI:1083674139
Name:MAZZARELLA, BARBARA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:MAZZARELLA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 EAST 43RD ST, 7TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4761
Mailing Address - Country:US
Mailing Address - Phone:917-355-7759
Mailing Address - Fax:
Practice Address - Street 1:211 EAST 43RD ST, 7TH FLOOR
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10017-4761
Practice Address - Country:US
Practice Address - Phone:917-355-7759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0500931041C0700X
NY050093-IR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical