Provider Demographics
NPI:1356600241
Name:RESNICK, BARBRA (LCSW)
Entity type:Individual
Prefix:
First Name:BARBRA
Middle Name:
Last Name:RESNICK
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 1:202 LOOKOUT PL
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4488
Mailing Address - Country:US
Mailing Address - Phone:407-310-4835
Mailing Address - Fax:
Practice Address - Street 1:202 LOOKOUT PL
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4488
Practice Address - Country:US
Practice Address - Phone:407-310-4835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW9451104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker