Provider Demographics
NPI:1316125156
Name:BARTLETT, DEBORAH HARVEY (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:HARVEY
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JODY
Other - Middle Name:HARVEY
Other - Last Name:BARTLETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3080 COLONY RD APT C
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5571
Mailing Address - Country:US
Mailing Address - Phone:919-401-2525
Mailing Address - Fax:
Practice Address - Street 1:3080 COLONY RD APT C
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5571
Practice Address - Country:US
Practice Address - Phone:919-401-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCOO23091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical