Provider Demographics
NPI:1417254012
Name:LUNETTA, DEBRA (LICSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:LUNETTA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:WEINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:91 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-3236
Mailing Address - Country:US
Mailing Address - Phone:508-946-0126
Mailing Address - Fax:
Practice Address - Street 1:2425 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-4508
Practice Address - Country:US
Practice Address - Phone:508-679-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10236071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical