MEDICARE: MS. DEBORAH KAYE RICH LCSW LPC MAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C001987	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235124090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH KAYE RICH LCSW LPC MAC

Provider Business Mailing Address
First Line	:	185 E NEW HAMPSHIRE AVE
Second Line	:
City	:	SOUTHERN PINES
State	:	NC
Zip	:	28387-5529
Country	:	US
Telephone Number	:	910-692-9100
Fax Number	:	910-692-9109

Provider Business Practice Location Address
First Line	:	185 E NEW HAMPSHIRE AVE
Second Line	:
City	:	SOUTHERN PINES
State	:	NC
Zip	:	28387-5529
Country	:	US
Telephone Number	:	910-692-9100
Fax Number	:	910-692-9109

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	01/10/2012

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