Healthcare Provider Details
I. General information
NPI: 1558662650
Provider Name (Legal Business Name): DEBRA ANNE FLINT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/05/2010
Last Update Date: 06/13/2020
Certification Date: 06/13/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2470 EASTBROOK RD
NEW CASTLE PA
16105-6314
US
IV. Provider business mailing address
2470 EASTBROOK RD
NEW CASTLE PA
16105-6314
US
V. Phone/Fax
- Phone: 412-496-7129
- Fax:
- Phone: 412-496-7129
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | CW017611 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | CW017611 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: