Provider Demographics
NPI:1457109860
Name:COY-WHEELER, DEBORAH A (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:COY-WHEELER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:A
Other - Last Name:COY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6453 FOREST GROVE DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-6503
Mailing Address - Country:US
Mailing Address - Phone:901-315-9596
Mailing Address - Fax:
Practice Address - Street 1:284 GERMAN OAK DR STE 100
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7276
Practice Address - Country:US
Practice Address - Phone:901-315-9596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000083071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical