Active NPI
Debra Ann Fludd, LCSWR
- Clinical Social Worker
- Ny, NY
National Provider Identifier
1275742058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R033087
- Practice address
- 2089 Third Avenue
Ny, NY 10029 - Phone
- (212) 828-6235
- Fax
- (212) 828-6145
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R033087 | NY | Primary |
Addresses
Primary practice location
2089 Third Avenue
Ny, NY 10029
Mailing address
1977 Powell Avenue
Bronx, NY 10472
Phone (718) 597-0503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R033087 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275742058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1977 POWELL AVENUE",
"city": "BRONX",
"state": "NY",
"postal_code": "10472",
"telephone_number": "718-597-0503",
"fax_number": "212-828-6145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2089 THIRD AVENUE",
"city": "NY",
"state": "NY",
"postal_code": "10029",
"telephone_number": "212-828-6235",
"fax_number": "212-828-6145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLUDD",
"first_name": "DEBRA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LCSWR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R033087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ny, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.