Provider Demographics
NPI:1215505789
Name:DEBORAH J. HARRELL, MSW
Entity type:Organization
Organization Name:DEBORAH J. HARRELL, MSW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:706-566-9582
Mailing Address - Street 1:185 MARIGOLD RD
Mailing Address - Street 2:
Mailing Address - City:OCILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31774
Mailing Address - Country:US
Mailing Address - Phone:706-566-9582
Mailing Address - Fax:
Practice Address - Street 1:185 MARIGOLD RD
Practice Address - Street 2:
Practice Address - City:OCILLA
Practice Address - State:GA
Practice Address - Zip Code:31774-2551
Practice Address - Country:US
Practice Address - Phone:706-566-9582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty