Provider Demographics
NPI:1336237148
Name:HARRISON, DEBORAH S (ACSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:S
Last Name:HARRISON
Suffix:
Gender:F
Credentials:ACSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28563
Mailing Address - Country:US
Mailing Address - Phone:252-638-3881
Mailing Address - Fax:252-638-8820
Practice Address - Street 1:504 POLLOCK STREET
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562
Practice Address - Country:US
Practice Address - Phone:252-638-3881
Practice Address - Fax:252-638-8820
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0003901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002756Medicaid
NC61133OtherBCBS
NC61133OtherBCBS