Provider Demographics
NPI:1649601899
Name:BALDINO, DEBORAH MARIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:MARIE
Last Name:BALDINO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:DEBORAH
Other - Middle Name:MARIE
Other - Last Name:ROOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:11 ERIN CT
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-2401
Mailing Address - Country:US
Mailing Address - Phone:631-650-1194
Mailing Address - Fax:
Practice Address - Street 1:11 ERIN CT
Practice Address - Street 2:
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-2401
Practice Address - Country:US
Practice Address - Phone:631-650-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051558-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker