Provider Demographics
NPI:1114039328
Name:DENA R BARASH L C S W L M F T P A
Entity Type:Organization
Organization Name:DENA R BARASH L C S W L M F T P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DENA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BARASH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LMFT
Authorized Official - Phone:561-361-9449
Mailing Address - Street 1:11210 HARBOUR SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1248
Mailing Address - Country:US
Mailing Address - Phone:561-488-4414
Mailing Address - Fax:561-852-2107
Practice Address - Street 1:7200 W CAMINO REAL
Practice Address - Street 2:SUITE 401
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5511
Practice Address - Country:US
Practice Address - Phone:561-488-4414
Practice Address - Fax:561-852-2107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14331041C0700X
FL879106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2062Medicare PIN