Provider Demographics
NPI:1659676922
Name:DEBRA J BRODSKY LCSW
Entity Type:Organization
Organization Name:DEBRA J BRODSKY LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-510-7297
Mailing Address - Street 1:200 S SERVICE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2133
Mailing Address - Country:US
Mailing Address - Phone:908-510-7297
Mailing Address - Fax:
Practice Address - Street 1:200 S SERVICE RD STE 101
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2133
Practice Address - Country:US
Practice Address - Phone:908-510-7297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty