Healthcare Provider Details

I. General information

NPI: 1134312259
Provider Name (Legal Business Name): DEBORAH EASTER REMINES LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH EASTER SMITHSON LCSW-C

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 10/04/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12145 ELM ST
PRINCESS ANNE MD
21853-1358
US

IV. Provider business mailing address

314 FRANKLIN AVE UNIT 403
BERLIN MD
21811
US

V. Phone/Fax

Practice location:
  • Phone: 410-651-9852
  • Fax: 410-651-1279
Mailing address:
  • Phone: 630-281-0850
  • Fax: 410-651-1279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12002
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: