Provider Demographics
NPI:1336905553
Name:KEARSE-THOMAS, DEBRA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:J
Last Name:KEARSE-THOMAS
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 1:117 JEFFERSON AVE APT 23
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1674
Mailing Address - Country:US
Mailing Address - Phone:917-882-5323
Mailing Address - Fax:
Practice Address - Street 1:117 JEFFERSON AVE APT 23
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-1674
Practice Address - Country:US
Practice Address - Phone:917-882-5323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089666104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker