Provider Demographics
NPI:1700169018
Name:BARBUTO, VICTOR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:BARBUTO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 DUTCHESS TPKE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-1554
Mailing Address - Country:US
Mailing Address - Phone:845-486-4840
Mailing Address - Fax:845-483-1203
Practice Address - Street 1:900 DUTCHESS TPKE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-1554
Practice Address - Country:US
Practice Address - Phone:845-486-4840
Practice Address - Fax:845-483-1203
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR034097-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical