Deborah M. Derosa, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73075144 Issued in NY

Practice address

1000 Main St
Port Jefferson, NY 11777-2250

Phone

(631) 589-2389

Fax

(631) 476-2741

NPI assigned

Nov 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366512873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 HILARY ST",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691807",
            "telephone_number": "631-589-2389",
            "fax_number": "631-476-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772250",
            "telephone_number": "631-589-2389",
            "fax_number": "631-476-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "DEBORAH",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73075144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Michele Delio
• Matthew Delph, PA
• Jessica Marie Demaria
• Peter G Depasquale, PHD MSW
• Toni B Derman, LCSW
• Tulsi Desai, PT
• Michael Destefano, M.D.
• Jessica Lynn Devereaux, R.D.
• Alejandra Devine, LMSW
• Stacey R Dewan

• Clinical Social Worker in Port Jefferson, NY
• Providers in Port Jefferson, 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 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.

Verify at the official NPI Registry.