Provider Demographics
NPI:1952320707
Name:KOLLMANN, DEBORAH ANNE (LCSW-C, CADC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANNE
Last Name:KOLLMANN
Suffix:
Gender:F
Credentials:LCSW-C, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BARBARA LN
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-4720
Mailing Address - Country:US
Mailing Address - Phone:410-392-2990
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 1H, ROOM 221
Practice Address - Street 2:PERRY POINT VAMC
Practice Address - City:PERRYVILLE
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:800-949-1003
Practice Address - Fax:410-642-1852
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE677101YA0400X
MD053381041C0700X
DEQ1-00004131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)