Provider Demographics
NPI:1407073539
Name:BARSA DEL ALCAZAR, CHRISTINE LOUISE (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:BARSA DEL ALCAZAR
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VOORHEES RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1615
Mailing Address - Country:US
Mailing Address - Phone:732-418-1935
Mailing Address - Fax:732-418-1935
Practice Address - Street 1:6 VOORHEES RD
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1615
Practice Address - Country:US
Practice Address - Phone:732-418-1935
Practice Address - Fax:732-418-1935
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014554001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ650418Medicare ID - Type Unspecified