Healthcare Provider Details

I. General information

NPI: 1932141876
Provider Name (Legal Business Name): DEBORAH R ARMSTRONG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 USHERS RD NORTHWAY 10 EXECUTIVE PARK
BALLSTON LAKE NY
12019-1547
US

IV. Provider business mailing address

315 USHERS RD NORTHWAY 10 EXECUTIVE PARK
BALLSTON LAKE NY
12019-1547
US

V. Phone/Fax

Practice location:
  • Phone: 518-371-1192
  • Fax:
Mailing address:
  • Phone: 518-877-5911
  • Fax: 518-877-7574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR023977-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: