Debra Lograno Dazzo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

073436 Issued in NY

Practice address

204 Patchogue Rd
Port Jefferson Station, NY 11776-1021

Phone

(631) 473-1320

NPI assigned

Aug 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1194918110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EDEN DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 PATCHOGUE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761021",
            "telephone_number": "631-473-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGRANO DAZZO",
        "first_name": "DEBRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Livoti, PA-C
• Regina Lleras, M.S. CCC-SLP TSSLD
• Brittany Llobell, COTA/L
• Jessica Loftus, LMHC
• Christopher E Loglia, LCSW, CASAC
• Long Island Digestive Endoscopy Center, LLC
• Long Island Oral and Maxillofacial Surgery Associates LLP
• Long Island Select Healthcare, Inc.
• Sarah Corliss Wheeler Long, PSY.D.
• Elizabeth Loper, M.S. CCC-SLP

• Clinical Social Worker in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.