Healthcare Provider Details

I. General information

NPI: 1811448525
Provider Name (Legal Business Name): DEBORAH MCGLOTHLIN MSW LISW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W MAIN ST
SAINT CLAIRSVILLE OH
43950-1040
US

IV. Provider business mailing address

255 W MAIN ST
SAINT CLAIRSVILLE OH
43950-1040
US

V. Phone/Fax

Practice location:
  • Phone: 740-695-9447
  • Fax:
Mailing address:
  • Phone: 740-695-9447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI. 1600632
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP02942766
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: