Provider Demographics
NPI:1023846318
Name:BOITS, DEBORAH (LCSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BOITS
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 1:1708 E RUBY LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-6053
Mailing Address - Country:US
Mailing Address - Phone:574-850-5386
Mailing Address - Fax:
Practice Address - Street 1:1360 E GRAY ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-1851
Practice Address - Country:US
Practice Address - Phone:317-437-5787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34011222A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical