Provider Demographics
NPI:1831244532
Name:NEWCOMB, BARBARA KAY (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:KAY
Last Name:NEWCOMB
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 1:303 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-2539
Mailing Address - Country:US
Mailing Address - Phone:607-584-4465
Mailing Address - Fax:607-584-4584
Practice Address - Street 1:303 MAIN ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-2539
Practice Address - Country:US
Practice Address - Phone:607-584-4465
Practice Address - Fax:607-584-4584
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053892-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00618162Medicaid
NYR053892-1OtherLCSW LICENSE NUMBER
NYCC4292Medicare ID - Type UnspecifiedPERSONAL MEDICARE NUMBER
NYS92213Medicare UPIN
NYR053892-1OtherLCSW LICENSE NUMBER
NY00618162Medicaid