Clark, Debra Jean

Clark, Debra Jean is an sole proprietor health care provider with primary practice located at 10 Market St Suite 5, Oneonta NY 13820-2655. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Clark, Debra Jean can be contacted via phone (607) 432-1914.

Contact Information

Primary practice address
10 Market St Suite 5 Oneonta NY 13820-2655
Phone: (607) 432-1914
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X R058000-1 New York
Behavioral Health & Social Service Providers / Social Worker 104100000X R058000-1 New York

Profile Details

NPI number 1609896943
LBN Legal business name Clark, Debra Jean
Credentials LCSW-R
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2006
Last updated Dec 1st, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609896943 NPPES
New York Other 11662733 CAQH NUMBER

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