Provider Demographics
NPI:1629518790
Name:BARRY, EMMA (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:BARRY
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 N CANFIELD NILES RD
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-1110
Mailing Address - Country:US
Mailing Address - Phone:330-792-8093
Mailing Address - Fax:330-792-8253
Practice Address - Street 1:1051 N CANFIELD NILES RD
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-1110
Practice Address - Country:US
Practice Address - Phone:330-792-8093
Practice Address - Fax:330-792-8253
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1600411104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker