Dehorn, Gwendolyn C

Dehorn, Gwendolyn C is an sole proprietor health care provider with primary practice located at 150 W Angela Blvd , South Bend IN 46617-1101. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Dehorn, Gwendolyn C can be contacted via phone (574) 245-3920.

Contact Information

Primary practice address
150 W Angela Blvd South Bend IN 46617-1101
Phone: (574) 245-3920
Fax: (573) 232-5386
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 34003375 Indiana
Behavioral Health & Social Service Providers / Clinical 1041C0700X 34003375 Indiana

Profile Details

NPI number 1245237114
LBN Legal business name Dehorn, Gwendolyn C
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2005
Last updated Aug 27th, 2013 - about 11 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 1245237114 NPPES
Indiana Other 34003375 STATE LICENCE NUMBER
Indiana Other 00000018781300 STATE LICENCE NUMBER

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