Provider Demographics
NPI:1578808291
Name:DELORENZO, BARBARA D (MSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:D
Last Name:DELORENZO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 JOHNSON BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-6305
Mailing Address - Country:US
Mailing Address - Phone:530-573-7970
Mailing Address - Fax:530-543-6873
Practice Address - Street 1:1360 JOHNSON BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-8220
Practice Address - Country:US
Practice Address - Phone:530-573-7970
Practice Address - Fax:530-543-6873
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health