NPI 1003506924

Mary Derbish, LSW

Practitioner Clinical Social Worker Champaign, IL

Practice location

Address: 505 W University Ave STE 202-203, Champaign, IL 61820-3915
Phone: (224) 232-8057

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 150110706 (IL)

Other Social Worker providers in Illinois →

Registry record

NPI: 1003506924
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 May 2023
Record last updated: 12 May 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.