Provider Demographics
NPI:1972074680
Name:DEBOER, MADELINE BETH (LISW)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:BETH
Last Name:DEBOER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 RAYWOOD VW APT 137
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7736
Mailing Address - Country:US
Mailing Address - Phone:319-640-7909
Mailing Address - Fax:
Practice Address - Street 1:6750 WESTOWN PKWY STE 200-154
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7723
Practice Address - Country:US
Practice Address - Phone:319-640-7909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-07
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker