Healthcare Provider Details

I. General information

NPI: 1518051119
Provider Name (Legal Business Name): DEBORAH L CARPENTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20500 S LAGRANGE RD
FRANKFORT IL
60423-1356
US

IV. Provider business mailing address

9040 W 140TH ST UNIT 2C
ORLAND PARK IL
60462-2161
US

V. Phone/Fax

Practice location:
  • Phone: 815-806-9300
  • Fax:
Mailing address:
  • Phone: 708-590-6766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: