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General NPI Number Information
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NPI Number | 1477166288
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Entity Type | Individual
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Provider Name | DEBORAH A BURNS LISW
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Gender | Female
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 2100 N MAIN ST # 304
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City | CROWN POINT
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State | IN
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Zip | 46307-1877
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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Provider Business Mailing Address
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Address Line | 329 N WEST ST
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City | LIMA
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State | OH
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Zip | 45801-4332
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Country | US
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Telephone | 419-221-3072
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34011740A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2002218
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License Number State | OH
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