Provider Demographics
NPI:1447310156
Name:DAVIS-THOMPSON, BARBARA B (LCSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:B
Last Name:DAVIS-THOMPSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:BARBARA
Other - Middle Name:B
Other - Last Name:BOHAN-THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15 STUYVESANT OVAL, 8F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2019
Mailing Address - Country:US
Mailing Address - Phone:212-673-7583
Mailing Address - Fax:646-215-8334
Practice Address - Street 1:15 STUYVESANT OVAL, 8F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-2019
Practice Address - Country:US
Practice Address - Phone:212-673-7583
Practice Address - Fax:646-215-8334
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR052028-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNOH201Medicare UPIN