Provider Demographics
NPI:1437750791
Name:BELLINGHAUSEN, DEBORAH ANN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANN
Last Name:BELLINGHAUSEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:DEBBIE
Other - Middle Name:ANN
Other - Last Name:BELLINGHAUSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:18 COUNTRYWAY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-9026
Mailing Address - Country:US
Mailing Address - Phone:731-395-9964
Mailing Address - Fax:
Practice Address - Street 1:174 MURRAY GUARD DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3742
Practice Address - Country:US
Practice Address - Phone:731-300-2619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker