Provider Demographics
NPI:1629281480
Name:BARCLAY, DIANE H (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:H
Last Name:BARCLAY
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 1:176 W 87TH ST
Mailing Address - Street 2:SUITE 10D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2902
Mailing Address - Country:US
Mailing Address - Phone:212-580-2576
Mailing Address - Fax:
Practice Address - Street 1:176 W 87TH ST
Practice Address - Street 2:SUITE 10D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2902
Practice Address - Country:US
Practice Address - Phone:212-580-2576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR042581-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical