Provider Demographics
NPI:1801999370
Name:THEIS, DEBORAH A (LSCSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:THEIS
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N MAIN ST
Mailing Address - Street 2:STE 612
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-5251
Mailing Address - Country:US
Mailing Address - Phone:620-474-4979
Mailing Address - Fax:
Practice Address - Street 1:1 N MAIN ST
Practice Address - Street 2:STE 612
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5251
Practice Address - Country:US
Practice Address - Phone:620-899-4696
Practice Address - Fax:620-662-6658
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS35681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical