Provider Demographics
NPI:1972809218
Name:UNGER, DEBRA SUSAN (MSW, LCSW, ACSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUSAN
Last Name:UNGER
Suffix:
Gender:F
Credentials:MSW, LCSW, ACSW
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:UNGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW, ACSW
Mailing Address - Street 1:2711 E BRIGS BND
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-4402
Mailing Address - Country:US
Mailing Address - Phone:812-391-4652
Mailing Address - Fax:
Practice Address - Street 1:2711 E BRIGS BND
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-4402
Practice Address - Country:US
Practice Address - Phone:812-391-4652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003810A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical