Provider Demographics
NPI:1790877652
Name:KARNBAD, DEBORAH JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JANE
Last Name:KARNBAD
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 1:22 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3482
Mailing Address - Country:US
Mailing Address - Phone:718-997-9536
Mailing Address - Fax:516-977-3266
Practice Address - Street 1:102 45 67TH ROAD
Practice Address - Street 2:SUITE 1T
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-997-9536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR02024711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN6L521Medicare ID - Type Unspecified