Krista Deboer
Individual provider Active NPI Social Worker · Cassopolis, MI
NPI 1841782893 · NPPES record last updated Jun 5, 2018
Key facts
- NPI
- 1841782893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6801101501 (MI)
- Practice address
- 960 M 60 E
Cassopolis, MI 49031-9339 - Phone
- (269) 228-5121
- NPI assigned
- Jun 5, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801101501 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801101501 | MI | Yes |
Addresses
Primary practice location
960 M 60 E
Cassopolis, MI 49031-9339
Mailing address
960 M 60 E
Cassopolis, MI 49031-9339
Other providers in Cassopolis, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2018. 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.