Provider Demographics
NPI:1275050916
Name:HAGEN, DEBRAH K (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBRAH
Middle Name:K
Last Name:HAGEN
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 1:9503 MOUNTAIN SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-5352
Mailing Address - Country:US
Mailing Address - Phone:954-614-7826
Mailing Address - Fax:
Practice Address - Street 1:9503 MOUNTAIN SHADOWS DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-5352
Practice Address - Country:US
Practice Address - Phone:954-614-7826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical