Provider Demographics
NPI:1376662288
Name:KAKO, DEBORAH ANN (MA, MED, LMHC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:KAKO
Suffix:
Gender:F
Credentials:MA, MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 BRIDGE ST
Mailing Address - Street 2:APT. #3114
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-7416
Mailing Address - Country:US
Mailing Address - Phone:978-744-4808
Mailing Address - Fax:
Practice Address - Street 1:190 BRIDGE ST
Practice Address - Street 2:APT. #3114
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-7416
Practice Address - Country:US
Practice Address - Phone:978-744-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health