Provider Demographics
NPI:1134323330
Name:HAVENS, DEBRA KAY (LPCC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:HAVENS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:KAY
Other - Last Name:BOGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:784 HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:FRENCHBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40322-8123
Mailing Address - Country:US
Mailing Address - Phone:606-768-9190
Mailing Address - Fax:606-768-9180
Practice Address - Street 1:784 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:FRENCHBURG
Practice Address - State:KY
Practice Address - Zip Code:40322-8123
Practice Address - Country:US
Practice Address - Phone:606-768-9190
Practice Address - Fax:606-768-9180
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY103016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
9661687OtherAETNA
KY7100283570Medicaid
3251961OtherUNITED HEALTHCARE
000000543717OtherANTHEM BCBS
11754716OtherCAQH