Provider Demographics
NPI:1861539991
Name:SERABIAN-KAUFER, DEBORAH (MA,MSW,LICSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SERABIAN-KAUFER
Suffix:
Gender:F
Credentials:MA,MSW,LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CELONA DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-2515
Mailing Address - Country:US
Mailing Address - Phone:401-232-7058
Mailing Address - Fax:
Practice Address - Street 1:75 SOCKANOSSET CROSSROADS
Practice Address - Street 2:SUITE 108
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-330-1658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW012511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical