Provider Demographics
NPI:1194471151
Name:BARRY, DJENABOU (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DJENABOU
Middle Name:
Last Name:BARRY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:DJENABOU
Other - Middle Name:
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:275 8TH AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-1611
Mailing Address - Country:US
Mailing Address - Phone:212-420-2620
Mailing Address - Fax:
Practice Address - Street 1:275 8TH AVE FL 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1611
Practice Address - Country:US
Practice Address - Phone:212-420-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114895104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker