Provider Demographics
NPI:1104846088
Name:MCCARTER, DEBORAH L (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38872 PROCTOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-8035
Mailing Address - Country:US
Mailing Address - Phone:503-722-6950
Mailing Address - Fax:503-668-5593
Practice Address - Street 1:38872 PROCTOR BLVD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-8035
Practice Address - Country:US
Practice Address - Phone:503-722-6950
Practice Address - Fax:503-668-5593
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL14131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR080WCGMWHMedicare ID - Type Unspecified
ORR93824Medicare UPIN