Provider Demographics
NPI:1467665323
Name:DONALDSON, DEBRA J (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:DONALDSON
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 1:325 E MIDDLE COUNTRY RD
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2922
Mailing Address - Country:US
Mailing Address - Phone:631-678-3772
Mailing Address - Fax:
Practice Address - Street 1:325 E MIDDLE COUNTRY RD
Practice Address - Street 2:SUITE # 3
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2922
Practice Address - Country:US
Practice Address - Phone:631-678-3772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical