Individual
MR. BRUCE BARRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
239 GOLDEN HILL LN, KINGSTON, NY 12401
(845) 340-4023
Mailing address
239 GOLDEN HILL LN, KINGSTON, NY 12401-6441
(845) 486-2703
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R027586
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02538329
—
NY
Enumeration date
11/03/2006
Last updated
09/06/2018
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