Provider Demographics
NPI:1689712069
Name:FAZIO MCGRORY, BARBARA ELAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ELAINE
Last Name:FAZIO MCGRORY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:ELAINE
Other - Last Name:FAZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CAC
Mailing Address - Street 1:345 7TH AVE
Mailing Address - Street 2:1601
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5006
Mailing Address - Country:US
Mailing Address - Phone:347-210-6398
Mailing Address - Fax:
Practice Address - Street 1:345 7TH AVE
Practice Address - Street 2:1601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5006
Practice Address - Country:US
Practice Address - Phone:347-210-6398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2015-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0279721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY886449150OtherNASW
NYA300000709Medicare PIN