Provider Demographics
NPI:1033246319
Name:WEATHERBY, DEBORAH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:WEATHERBY
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 1:243 ELM ST
Mailing Address - Street 2:VALLEY REGIONAL HOSPITAL/RIVER VALLEY ASSOCIATES
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743
Mailing Address - Country:US
Mailing Address - Phone:603-542-1877
Mailing Address - Fax:603-543-5687
Practice Address - Street 1:243 ELM ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743
Practice Address - Country:US
Practice Address - Phone:603-542-1877
Practice Address - Fax:603-543-5687
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH8861041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH14Y012737801OtherBCBS
NH30426628Medicaid
FLZ3647Medicare ID - Type Unspecified
NHRF4687Medicare PIN
NH30426628Medicaid