Provider Demographics
NPI:1700912839
Name:PHILLIPS-TAYLOR, DEBORAH ADELE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ADELE
Last Name:PHILLIPS-TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:ADELE
Other - Last Name:PHILLIPS-TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:19 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2172
Mailing Address - Country:US
Mailing Address - Phone:609-234-0293
Mailing Address - Fax:609-714-1516
Practice Address - Street 1:19 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2172
Practice Address - Country:US
Practice Address - Phone:609-234-0293
Practice Address - Fax:609-714-1516
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013101001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical