Healthcare Provider Details

I. General information

NPI: 1538136809
Provider Name (Legal Business Name): DEBRA FRAN MACHADO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 PILGRIM LN
WESTBURY NY
11590-6241
US

IV. Provider business mailing address

117 PILGRIM LN
WESTBURY NY
11590-6241
US

V. Phone/Fax

Practice location:
  • Phone: 516-333-6626
  • Fax:
Mailing address:
  • Phone: 516-333-6626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR032272-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: