Healthcare Provider Details

I. General information

NPI: 1831214477
Provider Name (Legal Business Name): BARBARA FORD LANOIL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HERRICK DR
OLD TAPPAN NJ
07675-7204
US

IV. Provider business mailing address

1 HERRICK DR
OLD TAPPAN NJ
07675-7204
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-6931
  • Fax:
Mailing address:
  • Phone: 201-666-6931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC00035000
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierSC00035000
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerSOCIAL WORKER LICENCE #

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: