Provider Demographics
NPI:1568981611
Name:BAXTER, DEBRA JANE (LMSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JANE
Last Name:BAXTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 CASTER RD
Mailing Address - Street 2:
Mailing Address - City:SANDY CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:13145-3183
Mailing Address - Country:US
Mailing Address - Phone:315-816-6050
Mailing Address - Fax:
Practice Address - Street 1:232 CASTER RD
Practice Address - Street 2:
Practice Address - City:SANDY CREEK
Practice Address - State:NY
Practice Address - Zip Code:13145-3183
Practice Address - Country:US
Practice Address - Phone:315-816-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081298104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker