Provider Demographics
NPI:1699136291
Name:STILL, BARBARA (PSYD, LSW)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:STILL
Suffix:
Gender:F
Credentials:PSYD, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 N 53RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2301
Mailing Address - Country:US
Mailing Address - Phone:215-850-9819
Mailing Address - Fax:215-877-7668
Practice Address - Street 1:2241 N 53RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2301
Practice Address - Country:US
Practice Address - Phone:215-850-9819
Practice Address - Fax:215-877-7668
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW005282E104100000X, 1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool