Blumthal, Debra Louise

Blumthal, Debra Louise is an sole proprietor health care provider with primary practice located at 215 S Grand Ave W , Springfield IL 62704-3838. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Blumthal, Debra Louise can be contacted via phone (217) 744-3525.

Contact Information

Primary practice address
215 S Grand Ave W Springfield IL 62704-3838
Phone: (217) 744-3525
Fax: (217) 744-2525
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 180006218 Illinois

Profile Details

NPI number 1063541308
LBN Legal business name Blumthal, Debra Louise
Credentials NCC, LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 4th, 2007
Last updated Jul 31st, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063541308 NPPES
Illinois Other 180.006218 STATE LICENSE NUMBER-LCPC

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