Provider Demographics
NPI:1821607805
Name:DONNELLEY, DEBORAH ELLIOTT (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELLIOTT
Last Name:DONNELLEY
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 1:5640 TEAKWOOD TER
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3014
Mailing Address - Country:US
Mailing Address - Phone:773-208-1185
Mailing Address - Fax:
Practice Address - Street 1:4718 N ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2079
Practice Address - Country:US
Practice Address - Phone:719-696-9937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099266181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical