Provider Demographics
NPI:1609997162
Name:BARBETTA, PHILIP ALFRED (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:ALFRED
Last Name:BARBETTA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 WASHINGTON PL
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-9138
Mailing Address - Country:US
Mailing Address - Phone:212-505-6554
Mailing Address - Fax:732-747-0095
Practice Address - Street 1:71 WASHINGTON PL
Practice Address - Street 2:SUITE 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9138
Practice Address - Country:US
Practice Address - Phone:212-505-6554
Practice Address - Fax:732-747-0095
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03433511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical