Provider Demographics
NPI:1932267549
Name:GOVE, DEBRA K (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:K
Last Name:GOVE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7929 S US HIGHWAY 59
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-8508
Mailing Address - Country:US
Mailing Address - Phone:936-564-5010
Mailing Address - Fax:
Practice Address - Street 1:7929 S US HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75964-8508
Practice Address - Country:US
Practice Address - Phone:936-564-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical