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NPI Code Detail

MEDICARE: DEBORAH LYNN MANKITA LCSW

MEDICARE: DEBORAH LYNN MANKITA LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker081225NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659685634
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH LYNN MANKITA LCSW
Provider Business Mailing Address
First Line : 667 STONELEIGH AVE STE 202
Second Line :
City : CARMEL
State : NY
Zip : 10512-2455
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1501 BROADWAY STE 1505
Second Line :
City : NEW YORK
State : NY
Zip : 10036-5521
Country : US
Telephone Number : 332-245-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2010
Last Update Date : 12/29/2025

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