Provider Demographics
NPI:1194757211
Name:HAMBRIGHT, DEBORAH SUE (ACSW, MSW)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SUE
Last Name:HAMBRIGHT
Suffix:
Gender:F
Credentials:ACSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2018
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46581-2018
Mailing Address - Country:US
Mailing Address - Phone:574-269-3030
Mailing Address - Fax:574-269-4646
Practice Address - Street 1:503 E FT WAYNE ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3338
Practice Address - Country:US
Practice Address - Phone:574-269-3030
Practice Address - Fax:574-269-4646
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000675A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN142820AMedicare PIN