Provider Demographics
NPI:1982886016
Name:BARBARA J. DOBBS, LCSW, INC.
Entity Type:Organization
Organization Name:BARBARA J. DOBBS, LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-263-4002
Mailing Address - Street 1:4505 S WASATCH BLVD
Mailing Address - Street 2:SUITE 330A
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-4709
Mailing Address - Country:US
Mailing Address - Phone:801-263-4002
Mailing Address - Fax:801-274-3780
Practice Address - Street 1:4505 S WASATCH BLVD
Practice Address - Street 2:SUITE 330A
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-4709
Practice Address - Country:US
Practice Address - Phone:801-263-4002
Practice Address - Fax:801-274-3780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT91-13813035011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000057811Medicare PIN