Provider Demographics
NPI:1699720672
Name:STUBBERS, BARBARA W (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:W
Last Name:STUBBERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5190 26TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-2200
Mailing Address - Country:US
Mailing Address - Phone:941-753-7086
Mailing Address - Fax:941-794-8414
Practice Address - Street 1:5190 26TH ST W
Practice Address - Street 2:SUITE A
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-2255
Practice Address - Country:US
Practice Address - Phone:941-753-7086
Practice Address - Fax:941-794-8414
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00011511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ2007Medicare ID - Type Unspecified