1407910797 NPI number — MRS. DEBORAH MAE MAYHEW MSW, LCSW, PIP

Table of content: MRS. DEBORAH MAE MAYHEW MSW, LCSW, PIP (NPI 1407910797)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407910797 NPI number — MRS. DEBORAH MAE MAYHEW MSW, LCSW, PIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAYHEW
Provider First Name:
DEBORAH
Provider Middle Name:
MAE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCSW, PIP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RENFROE
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
HODGSON
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW, LCSW, PIP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407910797
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WRAMC, BLDG 2, ROOM 2J38
Provider Second Line Business Mailing Address:
6900 GEORGIA AVE. NW
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20307-5001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-782-8464
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WRAMC, BLDG 2, DEPARTMENT OF MEDICINE
Provider Second Line Business Practice Location Address:
6900 GEORGIA AVE NW
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20307-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-782-8464
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0909C , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)