Healthcare Provider Details

I. General information

NPI: 1730441148
Provider Name (Legal Business Name): DEBORAH FIXELL BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 E PUTNAM AVE
OLD GREENWICH CT
06870-1379
US

IV. Provider business mailing address

1445 E PUTNAM AVE
OLD GREENWICH CT
06870-1379
US

V. Phone/Fax

Practice location:
  • Phone: 917-509-7412
  • Fax:
Mailing address:
  • Phone: 917-509-7412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1036
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number000512-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number456820257
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: