Debra M Mordecai, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005693 Issued in CT

Practice address

46 West Avon Road
Suite 204
Avon, CT 06001-3679

Phone

(860) 307-8943

Fax

(860) 824-1469

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Debra M Carroll Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Farmington River Mental Health Specialists, LLC

  • Clinical Social Worker
  • Avon, CT
  • NPI 1669731360
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651363200000",
    "number": "1093753808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 WEST AVON ROAD",
            "address_2": "SUITE 204",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013679",
            "telephone_number": "860-307-8943",
            "fax_number": "860-824-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 WEST AVON ROAD",
            "address_2": "SUITE 204",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013679",
            "telephone_number": "860-307-8943",
            "fax_number": "860-824-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORDECAI",
        "first_name": "DEBRA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "CARROLL",
            "middle_name": "M",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mohsin Mirza
• Mitchell S Katz DDS and Associates, PC (Mitchell S Katz DDS and Associates)
• Fawzu Fusaini Mohammadu, MD
• Christopher L. Montes, M.A., N.C.P., F.D.C.
• Jamie Moore-Torres, LCSW
• Linda Moses, LCSW
• Motivate Health Care
• Jessica Mount, LCSW
• Mountain Physical Therapy and Sports Medicine, LLC
• Samuel Moy, PH.D.

• Clinical Social Worker in Avon, CT
• Providers in Avon, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.