Provider Demographics
NPI:1366627713
Name:FOULKES, DEBORAH (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:FOULKES
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1520
Mailing Address - Country:US
Mailing Address - Phone:917-846-9228
Mailing Address - Fax:
Practice Address - Street 1:111 DUNNELL RD STE 201
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2678
Practice Address - Country:US
Practice Address - Phone:973-330-8123
Practice Address - Fax:973-671-4616
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00423900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional