Provider Demographics
NPI:1669649489
Name:KOMSIC, BARBARA (LMSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:KOMSIC
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33-34 80TH ST.
Mailing Address - Street 2:ELMHURST SCHOOL-BASED MENTAL HEALTH CLINIC - ROOM B32
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1341
Mailing Address - Country:US
Mailing Address - Phone:718-899-0592
Mailing Address - Fax:718-335-9114
Practice Address - Street 1:33-34 80TH ST.
Practice Address - Street 2:ELMHURST SCHOOL-BASED MENTAL HEALTH CLINIC - ROOM B32
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-1341
Practice Address - Country:US
Practice Address - Phone:718-899-0592
Practice Address - Fax:718-335-9114
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067252-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical