Provider Demographics
NPI:1144314253
Name:PITMAN, DEBRA JANE (DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:JANE
Last Name:PITMAN
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 WHITEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-4050
Mailing Address - Country:US
Mailing Address - Phone:516-799-2408
Mailing Address - Fax:516-799-1571
Practice Address - Street 1:12 RED MAPLE DR N
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-1528
Practice Address - Country:US
Practice Address - Phone:516-799-2408
Practice Address - Fax:516-765-3676
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR023304-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY199321OtherMHN
NY7401525OtherGHI
NYP492112OtherOXFORD
NY147582OtherVALUE OPTIONS
NY1049706OtherCIGNA
NY7401525OtherGHI