Provider Demographics
NPI:1164748653
Name:MICHAEL, DEBORAH (LPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 E 14TH ST STE 304
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-4401
Mailing Address - Country:US
Mailing Address - Phone:307-262-8572
Mailing Address - Fax:
Practice Address - Street 1:141 S CENTER ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2537
Practice Address - Country:US
Practice Address - Phone:307-262-8572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WYLPC1248101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor