Provider Demographics
NPI:1831132216
Name:HARRIS, BARBARA B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:B
Last Name:HARRIS
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 1:1541 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-244-3908
Mailing Address - Fax:585-244-5137
Practice Address - Street 1:1541 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-244-3908
Practice Address - Fax:585-244-5137
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR01620211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0020620OtherGHI
NY010016202OtherBLUE CROSS
NY7700121OtherMVP
000926446001OtherBLUE CROSS BLUE SHIELD
NY7493463OtherAETNA
NY100348OtherPREFERRED CARE FK
10768137OtherCAQH
01768137Medicare UPIN
NY7700121OtherMVP