Provider Demographics
NPI:1740346915
Name:NAVEDO BARSA, BETTY ROSE (LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:BETTY
Middle Name:ROSE
Last Name:NAVEDO BARSA
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BIRCH BROOK RD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-2016
Mailing Address - Country:US
Mailing Address - Phone:914-202-8748
Mailing Address - Fax:914-202-8748
Practice Address - Street 1:740 W END AVE
Practice Address - Street 2:SUITE 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6246
Practice Address - Country:US
Practice Address - Phone:212-866-0065
Practice Address - Fax:914-202-8748
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR019695-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02555764Medicaid
NY07402876Medicare UPIN
NY7402876Medicare UPIN
NY02555764Medicaid