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General NPI Number Information
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NPI Number | 1649690900
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Entity Type | Individual
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Provider Name | TODD BARATZ
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Gender | Male
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 36 W 11TH ST GARDEN LEVEL #1
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City | NEW YORK
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State | NY
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Zip | 10011-8778
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Country | US
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Telephone | 646-539-8899
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Fax |
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Provider Business Mailing Address
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Address Line | 295 CLINTON AVE APT. E11
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City | BROOKLYN
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State | NY
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Zip | 11205-4748
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Country | US
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Telephone | 646-539-8899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH12901
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 006459
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License Number State | NY
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