Provider Demographics
NPI:1174684682
Name:BYRON, DEBORAH (LMHC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BYRON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 GOVERNOR ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3246
Mailing Address - Country:US
Mailing Address - Phone:401-490-3563
Mailing Address - Fax:401-490-3569
Practice Address - Street 1:208 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3246
Practice Address - Country:US
Practice Address - Phone:401-490-3563
Practice Address - Fax:401-490-3569
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI413426OtherBLUE CHIP