Provider Demographics
NPI:1962560052
Name:BRINSON, DEBRA ELAINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ELAINE
Last Name:BRINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:DEBRA
Other - Middle Name:ELAINE
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 689
Mailing Address - Street 2:ATTENTION: KATHY LENARD
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-0689
Mailing Address - Country:US
Mailing Address - Phone:205-755-8800
Mailing Address - Fax:205-755-8882
Practice Address - Street 1:2100 COUNTY SERVICES DR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-6150
Practice Address - Country:US
Practice Address - Phone:205-621-6070
Practice Address - Fax:205-755-8882
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2016-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1672C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
102I803093OtherMEDICARE PTAN #102I803093 ( FOR ALL LOCATIONS K040)
AL102I803093Medicare PIN