Provider Demographics
NPI:1033110093
Name:KAUFMAN, DEBORAH S (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 CONSTITUTION BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-4146
Mailing Address - Country:US
Mailing Address - Phone:941-539-1925
Mailing Address - Fax:941-927-2144
Practice Address - Street 1:2100 CONSTITUTION BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-4146
Practice Address - Country:US
Practice Address - Phone:941-539-1925
Practice Address - Fax:941-927-2144
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW48811041C0700X
FLSW 48811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL761994400Medicaid
FL761994400Medicaid