Provider Demographics
NPI:1154339950
Name:FLOYD, DEBORAH (LICSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:187 PILGRIM DR
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1928
Mailing Address - Country:US
Mailing Address - Phone:508-853-2912
Mailing Address - Fax:
Practice Address - Street 1:116 BELMONT ST RM 44
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2964
Practice Address - Country:US
Practice Address - Phone:508-219-7189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10326121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA62-00531OtherEVERCARE
MAP22678Medicare ID - Type Unspecified
MAUX6751Medicare PIN