Provider Demographics
NPI:1659089993
Name:WERTHEIM, DEBORAH E (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:WERTHEIM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 EXCELSIOR SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2723
Mailing Address - Country:US
Mailing Address - Phone:518-577-9066
Mailing Address - Fax:
Practice Address - Street 1:15 MAPLE DELL
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2969
Practice Address - Country:US
Practice Address - Phone:518-577-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091593-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty