Provider Demographics
NPI:1003430919
Name:DUSEK, DEBRA (LCDC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:DUSEK
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20051 HIGHWAY 279
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-1265
Mailing Address - Country:US
Mailing Address - Phone:214-335-1006
Mailing Address - Fax:
Practice Address - Street 1:20051 HIGHWAY 279
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-1265
Practice Address - Country:US
Practice Address - Phone:214-335-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13739101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty