Provider Demographics
NPI:1023651478
Name:KRESESKI, BARBARA A (LSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:KRESESKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:BARB
Other - Middle Name:A
Other - Last Name:SERINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1431 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:HARDING
Mailing Address - State:PA
Mailing Address - Zip Code:18643-7113
Mailing Address - Country:US
Mailing Address - Phone:570-262-7409
Mailing Address - Fax:
Practice Address - Street 1:4101 BIRNEY AVE
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1323
Practice Address - Country:US
Practice Address - Phone:570-961-3361
Practice Address - Fax:570-961-3364
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134205104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA14549743Medicaid