Provider Demographics
NPI:1609962372
Name:SHILKOFF, DEBORAH M (LICSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:M
Last Name:SHILKOFF
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 INTERVALE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1357
Mailing Address - Country:US
Mailing Address - Phone:617-868-2770
Mailing Address - Fax:
Practice Address - Street 1:124 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 440 SOUTH
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5813
Practice Address - Country:US
Practice Address - Phone:617-868-2770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA100532 11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical