Provider Demographics
NPI:1770646846
Name:SANDLER, DEBRA LYN (LCSW)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LYN
Last Name:SANDLER
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 1:285 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-7100
Mailing Address - Country:US
Mailing Address - Phone:609-653-8850
Mailing Address - Fax:609-601-1657
Practice Address - Street 1:285 PINE AVE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-7100
Practice Address - Country:US
Practice Address - Phone:609-653-8850
Practice Address - Fax:609-601-1657
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001884001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ190195OtherMHN
NJS26177Medicare ID - Type Unspecified
NJS26177Medicare UPIN