Provider Demographics
NPI:1760694806
Name:WARNER, DEBORAH JRG (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:JRG
Last Name:WARNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 ROCK STRAIN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4515
Mailing Address - Country:US
Mailing Address - Phone:603-444-1512
Mailing Address - Fax:866-599-7012
Practice Address - Street 1:262 COTTAGE ST
Practice Address - Street 2:SUITE 250
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4146
Practice Address - Country:US
Practice Address - Phone:603-444-1512
Practice Address - Fax:866-599-7012
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH526103TC0700X
NY008686-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT151149000OtherMAGELLAN VT
NH30426314Medicaid
NH1059863OtherCIGNA
NH12005OtherSSI NEW HAMPSHIRE
NH222684864OtherTRICARE
NH0803381Y0NH01OtherBC NEW HAMPSHIRE
NH6247OtherNH DCYF FOR 2110S
NH100083451OtherAPS HEALTHCARE EAP
VT1003571Medicaid
NHRE616001, GRP 000403Medicare PIN