Provider Demographics
NPI:1952994576
Name:BUSCEMI, DEBORAH L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:L
Last Name:BUSCEMI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:DEBORAH
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 ACACIA CIR UNIT 313
Mailing Address - Street 2:
Mailing Address - City:INDIAN HEAD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60525-9096
Mailing Address - Country:US
Mailing Address - Phone:708-257-4357
Mailing Address - Fax:
Practice Address - Street 1:123 ACACIA CIR UNIT 313
Practice Address - Street 2:
Practice Address - City:INDIAN HEAD PARK
Practice Address - State:IL
Practice Address - Zip Code:60525-9096
Practice Address - Country:US
Practice Address - Phone:708-257-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0100781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical