Provider Demographics
NPI:1801010624
Name:BARRETT, JOHANNA FALVEY (LCSW ACSW)
Entity Type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:FALVEY
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W 24TH ST
Mailing Address - Street 2:APT 4F
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-989-2289
Mailing Address - Fax:212-689-7745
Practice Address - Street 1:430 W 24TH ST
Practice Address - Street 2:APT 4F
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-989-2289
Practice Address - Fax:212-689-7745
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0149651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN34121Medicare ID - Type Unspecified