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General NPI Number Information
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NPI Number | 1013415819
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Entity Type | Organization
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Legal Business Name | BARR PRACTICE LCSW PLLC
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 15 LASALLE AVE STE 107
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City | KENMORE
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State | NY
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Zip | 14217-2641
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Country | US
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Telephone | 716-812-0472
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Fax | 716-939-2108
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Provider Business Mailing Address
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Address Line | 15 LASALLE AVE STE 107
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City | KENMORE
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State | NY
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Zip | 14217-2641
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Country | US
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Telephone | 716-812-0472
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Fax | 716-939-2108
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHATINA CHEREE BARR
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Credential | LCSW-R
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Telephone | 716-812-0472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 084706
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License Number State | NY
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