Provider Demographics
NPI:1457500274
Name:WELSH, DEBORAH JANE (EDD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:JANE
Last Name:WELSH
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FIRTREE LN
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9709
Mailing Address - Country:US
Mailing Address - Phone:315-479-7718
Mailing Address - Fax:
Practice Address - Street 1:404 OAK ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2997
Practice Address - Country:US
Practice Address - Phone:315-479-7718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000737-1101Y00000X
NY001183-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor