MEDICARE: MISS DEBORAH LYNN DETTMAN LCSW, LICSW, SUDP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LW00005466	WA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CP00001620	WA
3	1041C0700X	Clinical Social Worker	149.008106	IL

General Provider Information

NPI Number	:	1073127775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DEBORAH LYNN DETTMAN LCSW, LICSW, SUDP

Provider Business Mailing Address
First Line	:	1209 W SHERWIN AVE APT 809
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-2257
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 W SHERWIN AVE APT 809
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-2257
Country	:	US
Telephone Number	:	301-202-4424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2020
Last Update Date	:	09/01/2020

Similar Medicare Providers

1962335893 — KINGSFOIL COUNSELING PLLC
Practice Location Address:

1209 W SHERWIN AVE APT 807
CHICAGO, IL
60626-2257

Practice Phone: 518-347-7268
Practice Fax:

1588731541 — DR. KAREN A SCOTT DDS
Practice Location Address:

55 E WASHINTON STREET , 3102
CHICAGO, IL
60602-2257

Practice Phone: 312-332-2702
Practice Fax:

1043406028 — MRS. ROSA ABARCA
Practice Location Address:

2257 W 35TH ST
CHICAGO, IL
60609-1036

Practice Phone: 773-744-7343
Practice Fax:

1023349024 — MRS. RACHEL OUZTS
Practice Location Address:

3341 N SEMINARY AVE , APT. 3F
CHICAGO, IL
60657-2257

Practice Phone: 757-353-5562
Practice Fax:

1568935658 — JESSIE RONAYNE
Practice Location Address:

3341 N SEMINARY AVE APT 2R
CHICAGO, IL
60657-2257

Practice Phone: 734-658-8766
Practice Fax:

1881291789 — JESSICA WEISBACH, LLC
Practice Location Address:

2257 N KEDZIE BLVD APT 3
CHICAGO, IL
60647-2561

Practice Phone: 847-971-4314
Practice Fax:

Directions to “ MISS DEBORAH LYNN DETTMAN LCSW, LICSW, SUDP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.