Provider Demographics
NPI:1801986674
Name:GALLOWAY, DEBORAH EILEEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:EILEEN
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2400 SE MIDPORT RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-4823
Mailing Address - Country:US
Mailing Address - Phone:772-398-1003
Mailing Address - Fax:772-398-1772
Practice Address - Street 1:2400 SE MIDPORT RD
Practice Address - Street 2:SUITE 211
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-4823
Practice Address - Country:US
Practice Address - Phone:772-398-1003
Practice Address - Fax:772-398-1772
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW61331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical