Provider Demographics
NPI:1427125749
Name:GARRISON, DEBORAH LYNN (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNN
Last Name:GARRISON
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 1:319 MAIN ST
Mailing Address - Street 2:STE 510
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-0710
Mailing Address - Country:US
Mailing Address - Phone:608-796-1114
Mailing Address - Fax:
Practice Address - Street 1:319 MAIN ST
Practice Address - Street 2:STE 510
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-0710
Practice Address - Country:US
Practice Address - Phone:608-796-1114
Practice Address - Fax:608-796-1944
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1518-1231041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN395R0GAOtherBCBS ATRUIM AWARE
#9646157 #0007329775OtherAETNA
MN117590 1OtherUCARE
WI770607630012OtherBC/BS PPO,POS,PAR,COMPCARE BLUE
WI39567400Medicaid
367319OtherMHN
MN827081300Medicaid
MN395R0GAOtherBCBS ATRUIM AWARE