Provider Demographics
NPI:1154466639
Name:WOODWORTH FIORI, DEBRA LEE (CASAC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:LEE
Last Name:WOODWORTH FIORI
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:LEE
Other - Last Name:WOODWORTH FIORI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:2734 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456
Mailing Address - Country:US
Mailing Address - Phone:315-781-0895
Mailing Address - Fax:
Practice Address - Street 1:WAYNE BEHAVIORAL HEALTH NETOWORK
Practice Address - Street 2:1519 NYE ROAD
Practice Address - City:LYONS
Practice Address - State:NY
Practice Address - Zip Code:14489
Practice Address - Country:US
Practice Address - Phone:315-946-5722
Practice Address - Fax:315-946-7066
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3774101YA0400X
000948 1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health