Provider Demographics
NPI:1043369663
Name:SANTORA, DEBRA (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:SANTORA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:GOLD SANTORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:189 REILLY RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-6100
Mailing Address - Country:US
Mailing Address - Phone:914-450-9474
Mailing Address - Fax:
Practice Address - Street 1:316 TITUSVILLE RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2944
Practice Address - Country:US
Practice Address - Phone:914-450-9474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04352011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical