Basic Information
| Provider Information | |||||||||
| NPI: | 1952468456 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARRETT | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 875 W 181ST ST | ||||||||
| Address2: | APT. 3A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100334468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147377338 | ||||||||
| FaxNumber: | 9147371050 | ||||||||
| Practice Location | |||||||||
| Address1: | 875 W 181ST ST | ||||||||
| Address2: | APT. 3A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100334468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147377338 | ||||||||
| FaxNumber: | 9147371050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2007 | ||||||||
| LastUpdateDate: | 10/16/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 055107 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 219936 | 01 | NY | HEALTHNET | OTHER | 140055107NY01 | 01 | NY | ANTHEM | OTHER |