Provider Demographics
NPI:1023319399
Name:ALICEA, BARRY BELL (LMSW)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:BELL
Last Name:ALICEA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 OUTLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1118
Mailing Address - Country:US
Mailing Address - Phone:917-557-7359
Mailing Address - Fax:
Practice Address - Street 1:1402 OUTLOOK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-1118
Practice Address - Country:US
Practice Address - Phone:917-557-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0731861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$OtherNONE