Provider Demographics
NPI:1679234777
Name:MULGREW, DEBORAH LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:MULGREW
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 E EMELITA CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-2881
Mailing Address - Country:US
Mailing Address - Phone:480-567-2728
Mailing Address - Fax:
Practice Address - Street 1:21321 E OCOTILLO RD STE 113
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5994
Practice Address - Country:US
Practice Address - Phone:480-493-5799
Practice Address - Fax:888-975-3287
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-01
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-18800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker