Provider Demographics
NPI:1588606198
Name:EPPS, DEBORAH JAMES (L-CSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JAMES
Last Name:EPPS
Suffix:
Gender:F
Credentials:L-CSW, BCD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:149 EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-4100
Mailing Address - Country:US
Mailing Address - Phone:516-485-5710
Mailing Address - Fax:516-485-4225
Practice Address - Street 1:175 FULTON AVE
Practice Address - Street 2:STE309
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3718
Practice Address - Country:US
Practice Address - Phone:516-485-5710
Practice Address - Fax:516-485-4225
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYR033117-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN6J791Medicare ID - Type UnspecifiedNUMBER