Provider Demographics
NPI:1942351077
Name:AGREST, DEBORAH (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:AGREST
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 1:1841 BROADWAY
Mailing Address - Street 2:SUITE 1202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7603
Mailing Address - Country:US
Mailing Address - Phone:212-874-2803
Mailing Address - Fax:212-874-2803
Practice Address - Street 1:1841 BROADWAY
Practice Address - Street 2:SUITE 1202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:212-874-2803
Practice Address - Fax:212-874-2803
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077404-11041C0700X
CT71341041C0700X
NJ44SC053816001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical