Provider Demographics
NPI:1275157489
Name:BARRIE BIRGE THERAPY, LLC
Entity Type:Organization
Organization Name:BARRIE BIRGE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, RTT, C HYP
Authorized Official - Phone:504-475-2604
Mailing Address - Street 1:23 HIDDEN POND LN
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-2230
Mailing Address - Country:US
Mailing Address - Phone:504-475-2604
Mailing Address - Fax:
Practice Address - Street 1:23 HIDDEN POND LN
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-2230
Practice Address - Country:US
Practice Address - Phone:504-475-2604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty