Doctor Name: | MR. BARRY POMERANTZ |
NPI Number: | 1811064553 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LICSW |
License Number: | 951 |
Business Practice Address: | 34 Lincoln St Newton Highlands, MA - 024611507 |
Business Phone Number: | 6179641060 |
Business Fax Number: | 6176300381 |
Mailing Address: | 15 Oak Ter, NEWTON |
State: | MA |
Postal Code: | 024611409 |
Phone Number: | 6179646497 |
Fax Number: | |
NPI Enumeration Date: | 11/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 951 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |