Provider Demographics
NPI:1639067499
Name:DEATON, DEANNA (PHD, MSW)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:DEATON
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 OWENS RD
Mailing Address - Street 2:
Mailing Address - City:FORT MITCHELL
Mailing Address - State:AL
Mailing Address - Zip Code:36856-5514
Mailing Address - Country:US
Mailing Address - Phone:334-540-3949
Mailing Address - Fax:
Practice Address - Street 1:190 OWENS RD
Practice Address - Street 2:
Practice Address - City:FORT MITCHELL
Practice Address - State:AL
Practice Address - Zip Code:36856-5514
Practice Address - Country:US
Practice Address - Phone:334-540-3949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI135587-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker