Provider Demographics
NPI:1861796278
Name:LEVI, DEBORAH SUE (LSCW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUE
Last Name:LEVI
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:SUE
Other - Last Name:LEVI LANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSCW
Mailing Address - Street 1:16019 VIA SHAVANO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2370
Mailing Address - Country:US
Mailing Address - Phone:210-326-4294
Mailing Address - Fax:
Practice Address - Street 1:16019 VIA SHAVANO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2370
Practice Address - Country:US
Practice Address - Phone:210-326-4294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical