Provider Demographics
NPI:1366684664
Name:WEBER, BARBARA J (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:WEBER
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 1:621 S NEW BALLAS RD
Mailing Address - Street 2:STE 6017B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-4652
Mailing Address - Fax:314-251-5715
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:STE 6017B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-4652
Practice Address - Fax:314-251-5715
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030202001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA1128003Medicare PIN