Provider Demographics
NPI:1538117668
Name:LEVY, BARBARA G (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:G
Last Name:LEVY
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 1:605 BROAD AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-1697
Mailing Address - Country:US
Mailing Address - Phone:800-932-0476
Mailing Address - Fax:201-943-8733
Practice Address - Street 1:28 MILLBURN AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1039
Practice Address - Country:US
Practice Address - Phone:973-218-1776
Practice Address - Fax:973-989-4448
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC04308000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ591153Medicare UPIN
NJ032211Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER