Provider Demographics
NPI:1336566777
Name:BUMBAUGH, DEBORAH MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:MARIE
Last Name:BUMBAUGH
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 1:6624 COLTON CRAWFORD CIR APT 305
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-6655
Mailing Address - Country:US
Mailing Address - Phone:410-960-8833
Mailing Address - Fax:
Practice Address - Street 1:3120 FAIRVIEW PARK DR STE 240
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-4569
Practice Address - Country:US
Practice Address - Phone:703-228-1600
Practice Address - Fax:703-228-1117
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040081211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical