Provider Demographics
NPI:1467282517
Name:DEPORTO, DARLENE (PHD)
Entity type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:
Last Name:DEPORTO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 DIDDELL RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6224
Mailing Address - Country:US
Mailing Address - Phone:845-797-0844
Mailing Address - Fax:
Practice Address - Street 1:80 DIDDELL RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6224
Practice Address - Country:US
Practice Address - Phone:845-797-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018599103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling