Provider Demographics
NPI:1154526911
Name:RAPTOPOULOS, DEBORAH (MSW, LICSW)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:RAPTOPOULOS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 BEACON ST
Mailing Address - Street 2:APT 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-1111
Mailing Address - Country:US
Mailing Address - Phone:617-739-9363
Mailing Address - Fax:617-232-1889
Practice Address - Street 1:404 BEACON ST
Practice Address - Street 2:APT 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-1111
Practice Address - Country:US
Practice Address - Phone:617-739-9363
Practice Address - Fax:617-232-1889
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10179951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1853872Medicaid
MA1853872Medicaid