Provider Demographics
NPI:1518598531
Name:DEBRA S SOMERVILL LMSW LLC
Entity Type:Organization
Organization Name:DEBRA S SOMERVILL LMSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOMERVILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-474-0747
Mailing Address - Street 1:1214 S COCHRAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-2206
Mailing Address - Country:US
Mailing Address - Phone:517-474-0747
Mailing Address - Fax:517-323-9531
Practice Address - Street 1:1214 S COCHRAN AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-2206
Practice Address - Country:US
Practice Address - Phone:517-474-0747
Practice Address - Fax:517-323-9531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty