Provider Demographics
NPI:1649459074
Name:HAGGETT, DEBORAH I (EDD, LCSW)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:I
Last Name:HAGGETT
Suffix:
Gender:F
Credentials:EDD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:TABERNACLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-8525
Mailing Address - Country:US
Mailing Address - Phone:856-988-9727
Mailing Address - Fax:609-268-2573
Practice Address - Street 1:17 RED OAK DR
Practice Address - Street 2:
Practice Address - City:TABERNACLE
Practice Address - State:NJ
Practice Address - Zip Code:08088-8525
Practice Address - Country:US
Practice Address - Phone:856-988-9727
Practice Address - Fax:609-268-2573
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045013001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0094617OtherPARTNERSHIP FOR CHILDREN