Provider Demographics
NPI:1902881113
Name:RACO, BARBARA ANN (LSCW R)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:RACO
Suffix:
Gender:F
Credentials:LSCW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 N GOODMAN ST
Mailing Address - Street 2:STE 111
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1554
Mailing Address - Country:US
Mailing Address - Phone:585-271-3760
Mailing Address - Fax:
Practice Address - Street 1:16 N GOODMAN ST
Practice Address - Street 2:STE 111
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1554
Practice Address - Country:US
Practice Address - Phone:585-271-3760
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY102052FKOtherPREFERRED CARE
16412OtherUNITED BEHAVIORAL HEALTH
748307OtherAETNA
2177456OtherFIRST HEALTH
7700263OtherMVP
NY0214L147Medicaid
2177456OtherFIRST HEALTH