Provider Demographics
NPI:1396634424
Name:DEBRAH, JOANNE (MED, CAGS)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:DEBRAH
Suffix:
Gender:F
Credentials:MED, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-2631
Mailing Address - Country:US
Mailing Address - Phone:401-243-3301
Mailing Address - Fax:
Practice Address - Street 1:991 PROVIDENCE HWY
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5001
Practice Address - Country:US
Practice Address - Phone:774-381-9648
Practice Address - Fax:877-800-9185
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health