Provider Demographics
NPI:1659589448
Name:EHRENBERG, BARBARA FRANCES (LSCW, PHD)
Entity Type:Individual
Prefix:PROF
First Name:BARBARA
Middle Name:FRANCES
Last Name:EHRENBERG
Suffix:
Gender:F
Credentials:LSCW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12449 GATELY OAKS LN E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-3982
Mailing Address - Country:US
Mailing Address - Phone:904-997-6616
Mailing Address - Fax:904-379-4757
Practice Address - Street 1:12449 GATELY OAKS LN E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-3982
Practice Address - Country:US
Practice Address - Phone:904-997-6616
Practice Address - Fax:904-379-4757
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW1987103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist