Provider Demographics
NPI:1033237615
Name:FLEET, DEBORAH ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:FLEET
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3544
Mailing Address - Country:US
Mailing Address - Phone:401-301-8240
Mailing Address - Fax:
Practice Address - Street 1:1069 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3544
Practice Address - Country:US
Practice Address - Phone:401-660-0687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW021801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDD62399Medicaid
RI1104847946OtherTHE PROVIDENCE CENTER NPI
RI1033237615OtherUBH
RI007059509OtherMEDICARE