Provider Demographics
NPI:1265054720
Name:HOLDER, DEBRA HERSCHBERG (LCSW)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:HERSCHBERG
Last Name:HOLDER
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 1:7002 ROCKSPRING LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-5461
Mailing Address - Country:US
Mailing Address - Phone:909-496-4173
Mailing Address - Fax:
Practice Address - Street 1:4259 W SWAMP RD STE 404
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-1033
Practice Address - Country:US
Practice Address - Phone:610-892-3800
Practice Address - Fax:484-468-1412
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0217861041C0700X
CALCSW73544104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker