Provider Demographics
NPI:1801950357
Name:MARKS, BARBARA GOLD (LICSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:GOLD
Last Name:MARKS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 BEACON STREET
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3885
Mailing Address - Country:US
Mailing Address - Phone:617-277-2449
Mailing Address - Fax:617-731-9114
Practice Address - Street 1:1180 BEACON ST
Practice Address - Street 2:SUITE 4B
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3885
Practice Address - Country:US
Practice Address - Phone:617-277-2449
Practice Address - Fax:617-731-9114
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1021149101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA365476OtherMAGELLAN BEHAVIORAL HEALT
MAP-06-318OtherBLUE CROSS BLUE SHIELD
MA110082452AMedicaid
MA009855OtherHARVARD PILGRIM
MA161793OtherTRICARE
MA236287979OtherUNITED BEHAVIORAL HEALTH
MA365476OtherMAGELLAN BEHAVIORAL HEALT