Debrah Udom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW0000004094 Issued in TN

Practice address

1450 Battleground Dr
Murfreesboro, TN 37129-1750

Phone

(615) 904-7170

NPI assigned

Aug 12, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Debrah Sue Reed Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1447669684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 FOXCROFT RD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371285305",
            "telephone_number": "615-631-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BATTLEGROUND DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291750",
            "telephone_number": "615-904-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDOM",
        "first_name": "DEBRAH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRAH",
            "last_name": "REED",
            "middle_name": "SUE",
            "prefix": "MISS",
            "credential": "CMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.