Provider Demographics
NPI:1528581493
Name:DEAS, LENORA (MSW)
Entity Type:Individual
Prefix:MS
First Name:LENORA
Middle Name:
Last Name:DEAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10418 GLEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1182
Mailing Address - Country:US
Mailing Address - Phone:347-242-6358
Mailing Address - Fax:
Practice Address - Street 1:3524 BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLONIAL HGTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1320
Practice Address - Country:US
Practice Address - Phone:347-242-6358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator