Provider Demographics
NPI:1316565518
Name:BRINKLEY, DEBORAH JO (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JO
Last Name:BRINKLEY
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 1:17 SAMSONS CIR
Mailing Address - Street 2:
Mailing Address - City:CRIMORA
Mailing Address - State:VA
Mailing Address - Zip Code:24431-2330
Mailing Address - Country:US
Mailing Address - Phone:540-414-5552
Mailing Address - Fax:
Practice Address - Street 1:17 SAMSONS CIR
Practice Address - Street 2:
Practice Address - City:CRIMORA
Practice Address - State:VA
Practice Address - Zip Code:24431-2330
Practice Address - Country:US
Practice Address - Phone:540-414-5552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040120111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical