Provider Demographics
NPI:1578572756
Name:DEBOER, KERI IONE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KERI
Middle Name:IONE
Last Name:DEBOER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 DENALI ST STE 1606
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2753
Mailing Address - Country:US
Mailing Address - Phone:907-349-1743
Mailing Address - Fax:907-770-0448
Practice Address - Street 1:2550 DENALI ST STE 1606
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2753
Practice Address - Country:US
Practice Address - Phone:907-349-1743
Practice Address - Fax:907-770-0448
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical