Cruickshank, Debra L
Cruickshank, Debra L is an sole proprietor health care provider with primary practice located at 2919 Crossing Ct Suite 6, Champaign IL 61822-5903. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Cruickshank, Debra L can be contacted via phone (217) 727-8112.Contact Information
Primary practice address
2919 Crossing Ct Suite 6
Champaign IL 61822-5903
Phone: (217) 727-8112
Fax: (217) 531-2788
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X |
Profile Details
| NPI number | 1841477965 |
|---|---|
| LBN Legal business name | Cruickshank, Debra L |
| Credentials | MSW LCSW CSW-G |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2008 |
| Last updated | Feb 19th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841477965 | NPPES |
| Illinois | Other | IL787003 | MEDICARE PTAN INDIVIDUAL |
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