Provider Demographics
NPI:1558701375
Name:DOUGLASS, DEBORAH (MSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:DOUGLASS
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 1:632 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:PA
Mailing Address - Zip Code:15202-3039
Mailing Address - Country:US
Mailing Address - Phone:412-459-8004
Mailing Address - Fax:
Practice Address - Street 1:632 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:PA
Practice Address - Zip Code:15202-3039
Practice Address - Country:US
Practice Address - Phone:412-459-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health