Provider Demographics
NPI:1740357839
Name:RAUCH, BARBARA R (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:R
Last Name:RAUCH
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 1:30 E 76TH ST
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2700
Mailing Address - Country:US
Mailing Address - Phone:212-517-2640
Mailing Address - Fax:
Practice Address - Street 1:30 E 76TH ST
Practice Address - Street 2:SUITE 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2700
Practice Address - Country:US
Practice Address - Phone:212-517-2640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR021540-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02658280Medicaid
NYN29341Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER