Provider Demographics
NPI:1427407485
Name:VAN HAL, DEBORAH (LLMSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:VAN HAL
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 WOODRUFF AVE APT B10
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-4930
Mailing Address - Country:US
Mailing Address - Phone:517-896-2776
Mailing Address - Fax:
Practice Address - Street 1:2930 WOODRUFF AVE APT B10
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4930
Practice Address - Country:US
Practice Address - Phone:517-896-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010996801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical