Provider Demographics
NPI:1255319778
Name:OLDHAM, DEBORAH FAYE (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:FAYE
Last Name:OLDHAM
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7027
Mailing Address - Country:US
Mailing Address - Phone:336-841-1851
Mailing Address - Fax:
Practice Address - Street 1:1008 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7027
Practice Address - Country:US
Practice Address - Phone:336-841-1851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2946101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional