Provider Demographics
NPI:1962277095
Name:BARTH, CLAIRE SUZANNE
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:SUZANNE
Last Name:BARTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SCUDDERS LN
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD LANDING
Mailing Address - State:NY
Mailing Address - Zip Code:11547-3019
Mailing Address - Country:US
Mailing Address - Phone:516-637-8647
Mailing Address - Fax:
Practice Address - Street 1:102 SCUDDERS LN
Practice Address - Street 2:
Practice Address - City:GLENWOOD LANDING
Practice Address - State:NY
Practice Address - Zip Code:11547-3019
Practice Address - Country:US
Practice Address - Phone:516-637-8647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121716-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker