Provider Demographics
NPI:1205373818
Name:BARACH, REBECCA (LISW-S)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BARACH
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-5995
Mailing Address - Country:US
Mailing Address - Phone:888-364-5977
Mailing Address - Fax:216-302-3171
Practice Address - Street 1:2141 OVERLOOK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44106-5995
Practice Address - Country:US
Practice Address - Phone:888-364-5977
Practice Address - Fax:216-302-3171
Is Sole Proprietor?:No
Enumeration Date:2017-01-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86000326A101YA0400X
OHI.1700186-SUPV1041C0700X
IN34006716A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)