Provider Demographics
NPI:1093067308
Name:DEBBY A. KOFFSKEY, LCSW, LLC
Entity Type:Organization
Organization Name:DEBBY A. KOFFSKEY, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KOFFSKEY-BEECH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-255-9445
Mailing Address - Street 1:1501 E DE SOTO ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-3440
Mailing Address - Country:US
Mailing Address - Phone:850-255-9445
Mailing Address - Fax:
Practice Address - Street 1:1501 E DE SOTO ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3440
Practice Address - Country:US
Practice Address - Phone:850-255-9445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty