Provider Demographics
NPI:1396427480
Name:KURYLUK, BARBARA SUMMERS (LCSW, LADC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:SUMMERS
Last Name:KURYLUK
Suffix:
Gender:F
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-4022
Mailing Address - Country:US
Mailing Address - Phone:203-913-5586
Mailing Address - Fax:
Practice Address - Street 1:1549 FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06605-1935
Practice Address - Country:US
Practice Address - Phone:203-366-5817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0079011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical