Provider Demographics
NPI:1265539191
Name:DOBBS, BARBARA J (LCSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:DOBBS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 S WASATCH BLVD
Mailing Address - Street 2:SUITE 330 A
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-4709
Mailing Address - Country:US
Mailing Address - Phone:801-263-4002
Mailing Address - Fax:801-274-3780
Practice Address - Street 1:4505 S WASATCH BLVD
Practice Address - Street 2:SUITE 330 A
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-4709
Practice Address - Country:US
Practice Address - Phone:801-263-4002
Practice Address - Fax:801-274-3780
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13813035011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTR61101Medicare UPIN
UT005781101Medicare ID - Type Unspecified