Slade, Deberah Lee
Slade, Deberah Lee is an sole proprietor health care provider with primary practice located at 347 Resource Pkwy , Winder GA 30680-8364. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Slade, Deberah Lee can be contacted via phone (770) 354-6109.Contact Information
Primary practice address
347 Resource Pkwy
Winder GA 30680-8364
Phone: (770) 354-6109
Fax: (770) 995-1959
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW004077 | Georgia |
Profile Details
| NPI number | 1174756613 |
|---|---|
| LBN Legal business name | Slade, Deberah Lee |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 1st, 2009 |
| Last updated | Apr 22nd, 2011 - about 13 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 | 1174756613 | NPPES |
| Georgia | Other | 992898769A | MEDICAID-CMO ONLY |
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