Jervis, Deborah
Jervis, Deborah is an sole proprietor health care provider with primary practice located at 11120 S Crown Way Ste 1 , Wellington FL 33414-8718. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jervis, Deborah can be contacted via phone (352) 256-2877.Contact Information
Primary practice address
11120 S Crown Way Ste 1
Wellington FL 33414-8718
Phone: (352) 256-2877
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW6162 | Florida |
Profile Details
| NPI number | 1013132679 |
|---|---|
| LBN Legal business name | Jervis, Deborah |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 16th, 2007 |
| Last updated | Feb 8th, 2020 - about 4 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 | 1013132679 | NPPES |
| Florida | Other | Z039U | BLUE CROSS BLUE SHIELD |
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