Provider Demographics
NPI:1679829451
Name:SCHULTHEISS, DEBORAH JOY (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JOY
Last Name:SCHULTHEISS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:JOY
Other - Last Name:HARTQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:619 LAKE ROYALE
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-9585
Mailing Address - Country:US
Mailing Address - Phone:267-885-7686
Mailing Address - Fax:
Practice Address - Street 1:619 LAKE ROYALE
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-9585
Practice Address - Country:US
Practice Address - Phone:267-885-7686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0173871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical