Provider Demographics
NPI:1225245327
Name:WEST, DEBORAH GREEN
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:GREEN
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:G
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD ACSW
Mailing Address - Street 1:416 MOREWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1814
Mailing Address - Country:US
Mailing Address - Phone:412-682-0843
Mailing Address - Fax:
Practice Address - Street 1:4716 ELLSWORTH AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2842
Practice Address - Country:US
Practice Address - Phone:412-682-2573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW001301L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
4250630100001Medicare ID - Type Unspecified