Provider Demographics
NPI:1922319961
Name:ELLIS, DEBORAH BARON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:BARON
Last Name:ELLIS
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 1:157 EAST 86TH STREET
Mailing Address - Street 2:NEIGHBORHOOD COALITION FOR SHELTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:212-537-5170
Mailing Address - Fax:
Practice Address - Street 1:157 EAST 86TH STREET
Practice Address - Street 2:NEIGHBORHOOD COALITION FOR SHELTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:212-537-5170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR017583-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical