Provider Demographics
NPI:1417416025
Name:DEBOW, PATRICK (CPRS, CADC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:DEBOW
Suffix:
Gender:M
Credentials:CPRS, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 W MARKET ST STE 110
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-2344
Mailing Address - Country:US
Mailing Address - Phone:302-854-0626
Mailing Address - Fax:
Practice Address - Street 1:505 W MARKET ST STE 110
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-2344
Practice Address - Country:US
Practice Address - Phone:302-854-0626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1587101YA0400X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)