Provider Demographics
NPI:1376944900
Name:FAECHER, DEBRA SUE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:SUE
Last Name:FAECHER
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 1:330 E 71ST ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5274
Mailing Address - Country:US
Mailing Address - Phone:917-536-8571
Mailing Address - Fax:
Practice Address - Street 1:330 E 71ST ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5274
Practice Address - Country:US
Practice Address - Phone:917-536-8571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR059640-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical