Provider Demographics
NPI:1487661708
Name:PENDLETON, DEBORAH GENEVIEVE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:GENEVIEVE
Last Name:PENDLETON
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 1:832 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1108
Mailing Address - Country:US
Mailing Address - Phone:317-287-3729
Mailing Address - Fax:317-287-3739
Practice Address - Street 1:832 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1108
Practice Address - Country:US
Practice Address - Phone:317-686-5634
Practice Address - Fax:317-287-3739
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003758A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical