Provider Demographics
NPI:1013419233
Name:BARBARASCH, BETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:BARBARASCH
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 1:36 HAWTHORNE PL APT 5E
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3245
Mailing Address - Country:US
Mailing Address - Phone:609-540-8814
Mailing Address - Fax:
Practice Address - Street 1:80 POMPTON AVE STE 204
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2913
Practice Address - Country:US
Practice Address - Phone:862-234-9380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-03
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5903103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist