Provider Demographics
NPI:1073688362
Name:PRICE, DEBORAH D (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:D
Last Name:PRICE
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:857 POST RD # 318
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6041
Mailing Address - Country:US
Mailing Address - Phone:203-767-0610
Mailing Address - Fax:855-658-1411
Practice Address - Street 1:310 PENFIELD RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6614
Practice Address - Country:US
Practice Address - Phone:203-767-0610
Practice Address - Fax:855-658-1411
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2023-07-17
Deactivation Date:2023-03-29
Deactivation Code:
Reactivation Date:2023-04-26
Provider Licenses
StateLicense IDTaxonomies
CT0060521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004262094Medicaid
CT140006052CT01OtherANTHEM