Provider Demographics
NPI:1518182146
Name:BRINK, DEBORAH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:BRINK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1676
Mailing Address - Country:US
Mailing Address - Phone:616-772-1733
Mailing Address - Fax:616-879-0072
Practice Address - Street 1:300 S STATE ST
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1676
Practice Address - Country:US
Practice Address - Phone:616-772-1733
Practice Address - Fax:616-879-0072
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801064868104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker