Provider Demographics
NPI:1518051119
Name:CARPENTER, DEBORAH L (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:CARPENTER
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 1:9040 W 140TH ST
Mailing Address - Street 2:UNIT 2C
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2161
Mailing Address - Country:US
Mailing Address - Phone:708-590-6766
Mailing Address - Fax:
Practice Address - Street 1:20500 S LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1356
Practice Address - Country:US
Practice Address - Phone:815-806-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical