Provider Demographics
NPI:1003925082
Name:KMAN, DEBRA ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:KMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:LIVINGSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:479 COUNTY RD 33
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815
Mailing Address - Country:US
Mailing Address - Phone:607-334-5626
Mailing Address - Fax:
Practice Address - Street 1:60 MIDLAND DR
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1947
Practice Address - Country:US
Practice Address - Phone:607-336-9914
Practice Address - Fax:607-334-4881
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070839R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY618205OtherMVP MOHAWK VALLEY PLAN
NY575011OtherVALUE OPTIONS
NY575011OtherVALUE OPTIONS
P62810Medicare UPIN