Debra M Mahoney
Individual provider Active NPI Social Worker · Enterprise, FL
NPI 1669720876 · NPPES record last updated Aug 17, 2012
Key facts
- NPI
- 1669720876
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 51 Childrens Way
Enterprise, FL 32725-8135 - Phone
- (386) 668-4774
- Fax
- (386) 668-0542
- NPI assigned
- Aug 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
51 Childrens Way
Enterprise, FL 32725-8135
Mailing address
51 Childrens Way
Enterprise, FL 32725-8135
Phone (386) 668-4774
Other providers in Enterprise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.