Basic Information
Provider Information
NPI: 1720054430
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOLZ
FirstName: DEBORAH
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL
Address2: 1650 COCHRANE CIRCLE ATTN: CREDENTIALS OFFICE
City: FORT CARSON
State: CO
PostalCode: 809134604
CountryCode: US
TelephoneNumber: 7195267844
FaxNumber: 7195267984
Practice Location
Address1: USA MEDDAC EVANS ARMY COMMUNITY HOSPITAL
Address2: SOCIAL WORK SERVICE
City: FORT CARSON
State: CO
PostalCode: 809134604
CountryCode: US
TelephoneNumber: 7195264585
FaxNumber: 7195260608
Other Information
ProviderEnumerationDate: 02/23/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X991508COY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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