Provider Demographics
NPI:1326448978
Name:NIELSON, DEBORAH ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:NIELSON
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 1:2916 NW BUCKLIN HILL RD # 125
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8514
Mailing Address - Country:US
Mailing Address - Phone:360-550-4117
Mailing Address - Fax:360-625-6713
Practice Address - Street 1:1940 DEVILLE DR NW
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-1713
Practice Address - Country:US
Practice Address - Phone:360-550-4117
Practice Address - Fax:360-625-6713
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60689490101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2070391Medicaid