Provider Demographics
NPI:1760491583
Name:WITKOV, BARBARA DINAH (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:DINAH
Last Name:WITKOV
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 HENRY HUDSON PKWY
Mailing Address - Street 2:1411
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3836
Mailing Address - Country:US
Mailing Address - Phone:718-543-0504
Mailing Address - Fax:718-549-0829
Practice Address - Street 1:19 W 34TH ST # W
Practice Address - Street 2:PH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3006
Practice Address - Country:US
Practice Address - Phone:718-543-0504
Practice Address - Fax:718-549-0829
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR061097-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical