Provider Demographics
NPI:1699285197
Name:LAWRENCE, DEBRA JEAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JEAN
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 BRUNO CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-2670
Mailing Address - Country:US
Mailing Address - Phone:719-238-6894
Mailing Address - Fax:
Practice Address - Street 1:4776 EAGLERIDGE CIR
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2189
Practice Address - Country:US
Practice Address - Phone:719-553-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099246231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical