Healthcare Provider Details

I. General information

NPI: 1124181037
Provider Name (Legal Business Name): BARBARA S PHILIP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 10/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 LINCOLN AVENUE
STEAMBOAT SPRINGS CO
80477
US

IV. Provider business mailing address

PO BOX 770240
STEAMBOAT SPRINGS CO
80477
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-7637
  • Fax: 970-871-6811
Mailing address:
  • Phone: 970-879-7637
  • Fax: 970-871-6811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number989309
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: