Provider Demographics
NPI:1245482512
Name:HARADON, DEBORAH LYNNE
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNNE
Last Name:HARADON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5015
Mailing Address - Country:US
Mailing Address - Phone:845-485-7237
Mailing Address - Fax:845-339-2462
Practice Address - Street 1:220 ROGERS ST
Practice Address - Street 2:
Practice Address - City:ULSTER PARK
Practice Address - State:NY
Practice Address - Zip Code:12487-5015
Practice Address - Country:US
Practice Address - Phone:845-485-7237
Practice Address - Fax:845-339-2462
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-18
Last Update Date:2008-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041264011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical