Provider Demographics
NPI:1861531576
Name:MILLING, DEBRA (LISW)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:MILLING
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 ELMWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2419
Mailing Address - Country:US
Mailing Address - Phone:304-972-1149
Mailing Address - Fax:
Practice Address - Street 1:444 ELMWOOD RD
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2419
Practice Address - Country:US
Practice Address - Phone:304-972-1149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8764104100000X
OHI.21028871041C0700X
MAS1169621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker