Provider Demographics
NPI:1972556736
Name:ROLLER, DEBORAH D (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:ROLLER
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 1:503 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-1556
Mailing Address - Country:US
Mailing Address - Phone:859-835-2573
Mailing Address - Fax:
Practice Address - Street 1:222 W SHELBY ST
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:KY
Practice Address - Zip Code:41040-1140
Practice Address - Country:US
Practice Address - Phone:859-654-6327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-16991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical