Individual provider Active NPI

Deborah B. Deacon, L.C.S.W.

  • Clinical Social Worker
  • North Little Rock, AR
National Provider Identifier
1003860362
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1577-C Issued in AR
Practice address
1920 Main St
Suite 231
North Little Rock, AR 72114-2872
Phone
(501) 944-0030
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1577-C AR Primary

Addresses

Primary practice location

1920 Main St
Suite 231
North Little Rock, AR 72114-2872

Mailing address

331 Goshen Ave
North Little Rock, AR 72116-8933
Phone (501) 944-0030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050803001113 AR Practitioner - Clinical Social Worker 5698703262 Practice locations: North Little Rock, AR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1920 Main St
Suite 231
North Little Rock, AR 72114-2872
Phone (501) 944-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1577-CARMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1003860362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 GOSHEN AVE",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721168933",
            "telephone_number": "501-944-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 MAIN ST",
            "address_2": "SUITE 231",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721142872",
            "telephone_number": "501-944-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEACON",
        "first_name": "DEBORAH",
        "middle_name": "B.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1577-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.