Provider Demographics
NPI:1356678817
Name:MIEROP, DEBRA ANN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:MIEROP
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:MORSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 731
Mailing Address - Street 2:
Mailing Address - City:BLOOMVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13739-0731
Mailing Address - Country:US
Mailing Address - Phone:607-538-1508
Mailing Address - Fax:
Practice Address - Street 1:132 DELAWARE ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:WALTON
Practice Address - State:NY
Practice Address - Zip Code:13856-1486
Practice Address - Country:US
Practice Address - Phone:607-865-8255
Practice Address - Fax:607-865-7252
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067027104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker