Provider Demographics
NPI:1275553133
Name:HUML, DEBORAH ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:HUML
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:MCCORMICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2028 N. SEMINARY AVENUE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098
Mailing Address - Country:US
Mailing Address - Phone:815-338-3590
Mailing Address - Fax:815-337-4406
Practice Address - Street 1:2028 N. SEMINARY AVENUE
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098
Practice Address - Country:US
Practice Address - Phone:815-338-3590
Practice Address - Fax:815-337-4406
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0082131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P51189Medicare UPIN
IL200924Medicare ID - Type Unspecified