Provider Demographics
NPI:1316931827
Name:LAZARTE, DEBRA JEAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JEAN
Last Name:LAZARTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:DEBRA
Other - Middle Name:JEAN
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5440 OLD BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78417-9765
Mailing Address - Country:US
Mailing Address - Phone:361-779-2890
Mailing Address - Fax:361-854-0414
Practice Address - Street 1:5440 OLD BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78417-9765
Practice Address - Country:US
Practice Address - Phone:361-779-2890
Practice Address - Fax:361-854-0414
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040942702Medicaid
TX23045OtherSOCIAL WORK LICENSE NUMBR
TX00S65YMedicare UPIN
TX00S65YMedicare UPIN