1306956040 NPI number — BARBARA L. MONACO LCSW-R

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306956040 NPI number — BARBARA L. MONACO LCSW-R

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONACO
Provider First Name:
BARBARA
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW-R
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306956040
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37 PUTNAM RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HYDE PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12538-2328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-229-9765
Provider Business Mailing Address Fax Number:
845-229-0314

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 DAVIS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POUGHKEEPSIE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12603-2408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-454-4441
Provider Business Practice Location Address Fax Number:
845-229-0314
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R048795 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 260340 . This is a "EMPIRE/VALUE OPTIONS/GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P3655887 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 781295 . This is a "MVP HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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