Provider Demographics
NPI:1154482719
Name:TORELL, DEBORAH LOUISE (OTR, LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LOUISE
Last Name:TORELL
Suffix:
Gender:F
Credentials:OTR, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2767 STILL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-1182
Mailing Address - Country:US
Mailing Address - Phone:770-337-8390
Mailing Address - Fax:
Practice Address - Street 1:2767 STILL LAKE DR
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-1182
Practice Address - Country:US
Practice Address - Phone:770-337-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT001928225XP0200X
GALPC006555101YP2500X
GAMFT001195106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00800203BMedicaid