Provider Demographics
NPI:1891072518
Name:DEBORAH ZURSCHMIEDE PHD PA
Entity Type:Organization
Organization Name:DEBORAH ZURSCHMIEDE PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/COO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:DODD
Authorized Official - Last Name:ZURSCHMIEDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LCSW
Authorized Official - Phone:850-671-4646
Mailing Address - Street 1:2729 BLAIRSTONE LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-6074
Mailing Address - Country:US
Mailing Address - Phone:850-671-4646
Mailing Address - Fax:850-671-5857
Practice Address - Street 1:2729 BLAIRSTONE LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-6074
Practice Address - Country:US
Practice Address - Phone:850-671-4646
Practice Address - Fax:850-671-5857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLCSW 00019611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5447OtherBLUE CROSS/BLUE SHIELD
FLZ5447Medicare PIN