Healthcare Provider Details

I. General information

NPI: 1811064553
Provider Name (Legal Business Name): BARRY POMERANTZ LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 LINCOLN ST
NEWTON HIGHLANDS MA
02461-1507
US

IV. Provider business mailing address

15 OAK TER
NEWTON MA
02461-1409
US

V. Phone/Fax

Practice location:
  • Phone: 617-964-1060
  • Fax: 617-630-0381
Mailing address:
  • Phone: 617-964-6497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number951
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100974
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: