Provider Demographics
NPI:1457076598
Name:BARRY, ANITA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:ELIZABETH
Last Name:BARRY
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 1:150 SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:NY
Mailing Address - Zip Code:13778-2520
Mailing Address - Country:US
Mailing Address - Phone:607-237-2426
Mailing Address - Fax:
Practice Address - Street 1:3849 SADDLEMIRE RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-6231
Practice Address - Country:US
Practice Address - Phone:607-775-7521
Practice Address - Fax:607-669-4811
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094238-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical