Provider Demographics
NPI:1619112976
Name:WARD, DEBRA SUE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUE
Last Name:WARD
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 S PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5409
Mailing Address - Country:US
Mailing Address - Phone:301-745-1900
Mailing Address - Fax:301-745-4110
Practice Address - Street 1:113 S PROSPECT ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5409
Practice Address - Country:US
Practice Address - Phone:301-745-1900
Practice Address - Fax:301-745-4110
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2019-10-30
Deactivation Date:2019-09-14
Deactivation Code:
Reactivation Date:2019-10-30
Provider Licenses
StateLicense IDTaxonomies
MD145241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000395600Medicaid