Provider Demographics
NPI:1043958234
Name:EBERWEIN, DEBORAH GRACE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:GRACE
Last Name:EBERWEIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 COUNTY ROAD 7593
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-7764
Mailing Address - Country:US
Mailing Address - Phone:870-219-6312
Mailing Address - Fax:
Practice Address - Street 1:411 CALVARY CV
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-7099
Practice Address - Country:US
Practice Address - Phone:870-219-9610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9802-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker