Provider Demographics
NPI:1881012672
Name:LEGERE, DEBRA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:LEGERE
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 1:3436 RIVER HEIGHTS XING SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4500
Mailing Address - Country:US
Mailing Address - Phone:404-918-2674
Mailing Address - Fax:678-504-7775
Practice Address - Street 1:242 CREEKSTONE RDG
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3732
Practice Address - Country:US
Practice Address - Phone:404-918-2674
Practice Address - Fax:678-504-7775
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW-0059071041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical