Provider Demographics
NPI:1700052057
Name:DEBORAH E HEALEY MD PLC
Entity Type:Organization
Organization Name:DEBORAH E HEALEY MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER & SOLO PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-296-0456
Mailing Address - Street 1:100 EAST SOUTH STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5217
Mailing Address - Country:US
Mailing Address - Phone:434-298-0456
Mailing Address - Fax:
Practice Address - Street 1:100 EAST SOUTH STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5217
Practice Address - Country:US
Practice Address - Phone:434-298-0456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010386812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190000819OtherMEDICARE PROVIDER NUMBER
VA010007186Medicaid
VAC47470Medicare UPIN