Healthcare Provider Details

I. General information

NPI: 1538117668
Provider Name (Legal Business Name): BARBARA G LEVY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 MILLBURN AVE SUITE 5
SPRINGFIELD NJ
07081-1039
US

IV. Provider business mailing address

605 BROAD AVE SUITE 106
RIDGEFIELD NJ
07657-1697
US

V. Phone/Fax

Practice location:
  • Phone: 973-218-1776
  • Fax: 973-989-4448
Mailing address:
  • Phone: 800-932-0476
  • Fax: 201-943-8733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SC04308000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: