Provider Demographics
NPI:1548763345
Name:PHILLIPS, DEBORAH ANNE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANNE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ANNE
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 S CHURCH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 S CHURCH ST STE 105
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5435
Practice Address - Country:US
Practice Address - Phone:410-848-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-18
Last Update Date:2018-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD154131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical