Provider Demographics
NPI:1124181037
Name:PHILIP, BARBARA S (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:S
Last Name:PHILIP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 770240
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477
Mailing Address - Country:US
Mailing Address - Phone:970-879-7637
Mailing Address - Fax:970-871-6811
Practice Address - Street 1:810 LINCOLN AVENUE
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80477
Practice Address - Country:US
Practice Address - Phone:970-879-7637
Practice Address - Fax:970-871-6811
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9893091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO61526Medicare ID - Type Unspecified