Provider Demographics
NPI:1427351709
Name:BARBERI, TRACIE YVETTE (LCSW, OSW-C)
Entity type:Individual
Prefix:MRS
First Name:TRACIE
Middle Name:YVETTE
Last Name:BARBERI
Suffix:
Gender:F
Credentials:LCSW, OSW-C
Other - Prefix:MRS
Other - First Name:TRACIE
Other - Middle Name:YVETTE
Other - Last Name:BARBERI- MATTHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW; OSW-C
Mailing Address - Street 1:1118 AUDUBON DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3709
Mailing Address - Country:US
Mailing Address - Phone:732-831-0203
Mailing Address - Fax:
Practice Address - Street 1:1118 AUDUBON DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3709
Practice Address - Country:US
Practice Address - Phone:732-831-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045322001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical