Provider Demographics
NPI:1255472098
Name:SCHIFER, DEBRA KAY (LSW LICDC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:SCHIFER
Suffix:
Gender:F
Credentials:LSW LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 US HIGHWAY 42 SE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-9548
Mailing Address - Country:US
Mailing Address - Phone:740-845-8652
Mailing Address - Fax:614-503-0899
Practice Address - Street 1:1375 US HIGHWAY 42 SE
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-9548
Practice Address - Country:US
Practice Address - Phone:740-845-8652
Practice Address - Fax:614-503-0899
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH001273101YA0400X
OH50022849104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker