Provider Demographics
NPI:1144403858
Name:SHAIN, DEBORAH D (MSS LCSW BCD)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:D
Last Name:SHAIN
Suffix:
Gender:F
Credentials:MSS LCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 OLD YORK ROAD
Mailing Address - Street 2:607B
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027
Mailing Address - Country:US
Mailing Address - Phone:215-782-8666
Mailing Address - Fax:215-782-8272
Practice Address - Street 1:7900 OLD YORK ROAD
Practice Address - Street 2:607B
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2334
Practice Address - Country:US
Practice Address - Phone:215-782-8666
Practice Address - Fax:215-782-8272
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW154161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical