Healthcare Provider Details

I. General information

NPI: 1376699009
Provider Name (Legal Business Name): BARBARA DEUTSCH CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 WHITE FARM RD
WINGDALE NY
12594-1115
US

IV. Provider business mailing address

15 WHITE FARM RD
WINGDALE NY
12594-1115
US

V. Phone/Fax

Practice location:
  • Phone: 845-832-7349
  • Fax: 845-832-7349
Mailing address:
  • Phone: 845-832-7349
  • Fax: 845-832-7349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberR038261
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: