Provider Demographics
NPI:1023223039
Name:SCHRYVER, DEBORAH WALLDROFF (MS, LMHC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:WALLDROFF
Last Name:SCHRYVER
Suffix:
Gender:F
Credentials:MS, LMHC, NCC
Other - Prefix:MISS
Other - First Name:DEBORAH
Other - Middle Name:JEAN
Other - Last Name:WALLDROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42333 STATE ROUTE 12
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA BAY
Mailing Address - State:NY
Mailing Address - Zip Code:13607-2151
Mailing Address - Country:US
Mailing Address - Phone:315-686-6094
Mailing Address - Fax:
Practice Address - Street 1:42333 STATE ROUTE 12
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA BAY
Practice Address - State:NY
Practice Address - Zip Code:13607-2151
Practice Address - Country:US
Practice Address - Phone:315-686-6094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health