MEDICARE: DARLENE BARRY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	070211	NY

General Provider Information

NPI Number	:	1316005259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLENE BARRY LCSW

Provider Business Mailing Address
First Line	:	26 E PARK AVE
Second Line	:	SUITE 300
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3595
Country	:	US
Telephone Number	:	516-897-7609
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 E PARK AVE
Second Line	:	SUITE 300
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3595
Country	:	US
Telephone Number	:	516-897-7609
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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