Provider Demographics
NPI:1154042919
Name:CITRON, BARRY (LCSW)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:CITRON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 E OCEAN BLVD UNIT 1013
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-6020
Mailing Address - Country:US
Mailing Address - Phone:562-606-4099
Mailing Address - Fax:
Practice Address - Street 1:1750 E OCEAN BLVD UNIT 1013
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-6020
Practice Address - Country:US
Practice Address - Phone:562-606-4099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA177531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical