Provider Demographics
NPI:1912182270
Name:DEBORAH SUE HAMBRIGHT
Entity Type:Organization
Organization Name:DEBORAH SUE HAMBRIGHT
Other - Org Name:COUNSELING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-269-3030
Mailing Address - Street 1:PO BOX 2018
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46581-2018
Mailing Address - Country:US
Mailing Address - Phone:574-269-3030
Mailing Address - Fax:574-269-4646
Practice Address - Street 1:503 E FT WAYNE ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3338
Practice Address - Country:US
Practice Address - Phone:574-269-3030
Practice Address - Fax:574-269-4646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000675A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherIRS EIN
142820Medicare PIN