Provider Demographics
NPI:1376717090
Name:BARBARA PRIESTNER WERTE LCSW PC
Entity Type:Organization
Organization Name:BARBARA PRIESTNER WERTE LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PRIESTNER WERTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:845-986-1179
Mailing Address - Street 1:23 FEAGLES RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-2224
Mailing Address - Country:US
Mailing Address - Phone:845-986-1179
Mailing Address - Fax:
Practice Address - Street 1:23 FEAGLES RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-2224
Practice Address - Country:US
Practice Address - Phone:845-986-1179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-043516-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02847583Medicaid
NY02847583Medicaid
NYN5K102Medicare PIN