Provider Demographics
NPI:1558483925
Name:SORACE, BARBARA HELEN (MSW,LCSW,LCADC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:HELEN
Last Name:SORACE
Suffix:
Gender:F
Credentials:MSW,LCSW,LCADC
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:HELEN
Other - Last Name:DAKU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,LCSW,LCADC
Mailing Address - Street 1:19 N MELBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-1912
Mailing Address - Country:US
Mailing Address - Phone:609-487-0743
Mailing Address - Fax:
Practice Address - Street 1:701 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:LANOKA HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08734-1536
Practice Address - Country:US
Practice Address - Phone:609-487-0743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00107400101YA0400X
NJ44SC004794001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCP12068Medicaid
NJ004853C4BMedicare UPIN