Provider Demographics
NPI:1275668642
Name:CARBONE, DEBRA JANE (LPC RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JANE
Last Name:CARBONE
Suffix:
Gender:F
Credentials:LPC RN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:JANE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:128 EMBERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINNABOW
Mailing Address - State:NC
Mailing Address - Zip Code:28479-5186
Mailing Address - Country:US
Mailing Address - Phone:910-880-0234
Mailing Address - Fax:
Practice Address - Street 1:2425 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7903
Practice Address - Country:US
Practice Address - Phone:910-313-3232
Practice Address - Fax:910-313-6598
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4685101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1423TOtherBCBS