Provider Demographics
NPI:1770823783
Name:MOON, DEBORAH J (LCSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:MOON
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:JUNGRIM
Other - Middle Name:
Other - Last Name:MOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1761 STEVENSAN DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-3604
Mailing Address - Country:US
Mailing Address - Phone:412-256-8394
Mailing Address - Fax:443-923-1875
Practice Address - Street 1:1761 STEVENSAN DR
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-3604
Practice Address - Country:US
Practice Address - Phone:412-256-8394
Practice Address - Fax:443-923-1895
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18342104100000X
CT0116711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker