Burdick, Debra E
Burdick, Debra E is an sole proprietor health care provider with primary practice located at 310 River Road Ext , New Paltz NY 12561-3080. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Burdick, Debra E can be contacted via phone (845) 658-8083.Contact Information
Primary practice address
310 River Road Ext
New Paltz NY 12561-3080
Phone: (845) 658-8083
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 078801R | New York |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 003903 | Connecticut |
Profile Details
| NPI number | 1811939390 |
|---|---|
| LBN Legal business name | Burdick, Debra E |
| Credentials | LCSW, BCN |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 11th, 2006 |
| Last updated | Jan 20th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811939390 | NPPES |
| Connecticut | MEDICAID | 13400 |
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