Provider Demographics
NPI:1477649275
Name:STOBE, BARBARA LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LYNN
Last Name:STOBE
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 1:5036 JERICHO TURNPIKE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725
Mailing Address - Country:US
Mailing Address - Phone:631-462-5202
Mailing Address - Fax:631-462-5258
Practice Address - Street 1:5036 JERICHO TURNPIKE
Practice Address - Street 2:SUITE 203
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725
Practice Address - Country:US
Practice Address - Phone:631-462-5202
Practice Address - Fax:631-462-5258
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0567371104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNE1071Medicare ID - Type Unspecified