Provider Demographics
NPI:1609146497
Name:WALDMAN, DEBRA G (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:G
Last Name:WALDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DAYA
Other - Middle Name:
Other - Last Name:WALDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34601
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4601
Mailing Address - Country:US
Mailing Address - Phone:702-277-9426
Mailing Address - Fax:702-795-4141
Practice Address - Street 1:410 S RAMPART BLVD STE 390
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5749
Practice Address - Country:US
Practice Address - Phone:702-277-9426
Practice Address - Fax:702-795-4141
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8325-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical