Provider Demographics
NPI:1619034618
Name:BARR, AMY CARR (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CARR
Last Name:BARR
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 1:412 E 88TH ST
Mailing Address - Street 2:APT. 2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6614
Mailing Address - Country:US
Mailing Address - Phone:917-613-3085
Mailing Address - Fax:
Practice Address - Street 1:412 E 88TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6614
Practice Address - Country:US
Practice Address - Phone:917-613-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2015-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05301800104100000X
NY0831861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker