Provider Demographics
NPI:1427220631
Name:FUSS, DEBORAH A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:A
Last Name:FUSS
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 1:55 BLOOMFIELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522
Mailing Address - Country:US
Mailing Address - Phone:717-468-1130
Mailing Address - Fax:717-299-0875
Practice Address - Street 1:1689 CROWN AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6314
Practice Address - Country:US
Practice Address - Phone:717-468-1130
Practice Address - Fax:717-299-0875
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0155391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021246810002Medicaid
PA1021246810002Medicaid