Provider Demographics
NPI:1225851447
Name:HERNANDEZ, DEBORA A I (LMSW)
Entity type:Individual
Prefix:MISS
First Name:DEBORA
Middle Name:A
Last Name:HERNANDEZ
Suffix:I
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:DEBORA
Other - Middle Name:A
Other - Last Name:HERNANDEZ
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:14 SLOSSON TER
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2507
Mailing Address - Country:US
Mailing Address - Phone:718-273-8409
Mailing Address - Fax:
Practice Address - Street 1:14 SLOSSON TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2507
Practice Address - Country:US
Practice Address - Phone:718-273-0850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122633-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker