Provider Demographics
NPI:1104075936
Name:ZOBEL-GREY, DEANNA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:ZOBEL-GREY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BOULDER CRESCENT ST
Mailing Address - Street 2:STE 102F
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3345
Mailing Address - Country:US
Mailing Address - Phone:719-287-7832
Mailing Address - Fax:
Practice Address - Street 1:10 BOULDER CRESCENT ST
Practice Address - Street 2:STE 102F
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3345
Practice Address - Country:US
Practice Address - Phone:719-287-7832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CO13661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health