Provider Demographics
NPI:1689775801
Name:CORIELL, DEBORAH J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:J
Last Name:CORIELL
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 1:2212 WHISPERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059
Mailing Address - Country:US
Mailing Address - Phone:502-228-0330
Mailing Address - Fax:502-287-6197
Practice Address - Street 1:800 ZORN AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206
Practice Address - Country:US
Practice Address - Phone:502-287-5264
Practice Address - Fax:502-287-6197
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY363104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker