Provider Demographics
NPI:1497859979
Name:GREEN-LAUBER, DEBORAH SUSAN (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:SUSAN
Last Name:GREEN-LAUBER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3970 BROWN PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1166
Mailing Address - Country:US
Mailing Address - Phone:614-527-4335
Mailing Address - Fax:614-534-0033
Practice Address - Street 1:3970 BROWN PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1166
Practice Address - Country:US
Practice Address - Phone:614-534-0013
Practice Address - Fax:614-534-0033
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00049681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW08953Medicare ID - Type Unspecified