Provider Demographics
NPI:1992849632
Name:BARRIOS, CHARLES (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:BARRIOS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5065 42ND ST
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3127
Mailing Address - Country:US
Mailing Address - Phone:646-235-6133
Mailing Address - Fax:
Practice Address - Street 1:137 GARFIELD PL APT 1R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2005
Practice Address - Country:US
Practice Address - Phone:646-235-6133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0553911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical