Provider Demographics
NPI:1285952341
Name:PORTNAY, DEBORAH LYNNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LYNNE
Last Name:PORTNAY
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 1:1275 POST RD
Mailing Address - Street 2:SUITE 200B
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6015
Mailing Address - Country:US
Mailing Address - Phone:203-490-4737
Mailing Address - Fax:
Practice Address - Street 1:1275 POST RD
Practice Address - Street 2:SUITE 200B
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6015
Practice Address - Country:US
Practice Address - Phone:203-490-4737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005150106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist