Provider Demographics
NPI:1871581793
Name:KRIEGEL, DEBORAH K (LMHC)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:K
Last Name:KRIEGEL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 GRAPE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3015
Mailing Address - Country:US
Mailing Address - Phone:574-243-9370
Mailing Address - Fax:574-232-9375
Practice Address - Street 1:2410 GRAPE RD STE 1
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3015
Practice Address - Country:US
Practice Address - Phone:574-243-9370
Practice Address - Fax:574-232-9375
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000432A101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000368750OtherANTHEM
IN2301934OtherCIGNA
IN000000368750OtherUNICARE
IN267265000OtherMAGELLAN