Provider Demographics
NPI:1649463241
Name:SMITH, DEBORAH S (LCADC)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:G
Other - Last Name:SHUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95 MT. KEMBLE AVENUE
Mailing Address - Street 2:ATTN C. LAMPRON
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07962-1978
Mailing Address - Country:US
Mailing Address - Phone:973-971-4714
Mailing Address - Fax:973-290-7585
Practice Address - Street 1:99 BEAUVOIR AVENUE
Practice Address - Street 2:OP MH
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07920
Practice Address - Country:US
Practice Address - Phone:888-247-1400
Practice Address - Fax:973-290-7585
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00099200101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)