Provider Demographics
NPI:1043323256
Name:PAPPS, DEBRA J (LCSW)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:PAPPS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 BELFORT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-1219
Mailing Address - Country:US
Mailing Address - Phone:207-807-3112
Mailing Address - Fax:207-747-4682
Practice Address - Street 1:333 LINCOLN ST STE 217
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3113
Practice Address - Country:US
Practice Address - Phone:207-807-3112
Practice Address - Fax:207-747-4682
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC63441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME243020099Medicaid
MEMM7575Medicare ID - Type Unspecified