Provider Demographics
NPI:1750630810
Name:KRAUSE, BARRIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BARRIE
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 JOHNSON AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1619
Mailing Address - Country:US
Mailing Address - Phone:914-505-6755
Mailing Address - Fax:
Practice Address - Street 1:141 N CENTRAL AVE
Practice Address - Street 2:C/O WJCS
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1912
Practice Address - Country:US
Practice Address - Phone:914-949-7699
Practice Address - Fax:914-949-3224
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022423103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical