Provider Demographics
NPI:1316191257
Name:FUTTERMAN, DEBRA BETH (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:BETH
Last Name:FUTTERMAN
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 1:1021 NW 53RD STREET
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-8642
Mailing Address - Country:US
Mailing Address - Phone:954-298-0979
Mailing Address - Fax:
Practice Address - Street 1:7390 NW 5TH ST
Practice Address - Street 2:UNIT #5
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1610
Practice Address - Country:US
Practice Address - Phone:954-583-8831
Practice Address - Fax:954-583-9575
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW6829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL766412500Medicaid
FL761266400Medicaid