Provider Demographics
NPI:1841542149
Name:FITCH, DEBORAH VIVIAN (LCSW, LSCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:VIVIAN
Last Name:FITCH
Suffix:
Gender:F
Credentials:LCSW, LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21350 W 153RD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5413
Mailing Address - Country:US
Mailing Address - Phone:913-322-4900
Mailing Address - Fax:913-780-1284
Practice Address - Street 1:600 W MECHANIC AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-1769
Practice Address - Country:US
Practice Address - Phone:816-521-5540
Practice Address - Fax:816-521-5614
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120185801041C0700X
KS41661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical