Provider Demographics
NPI:1407869068
Name:HART, DEBORAH LEIGH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LEIGH
Last Name:HART
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S HEATHERWILDE BLVD # 2557
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3533
Mailing Address - Country:US
Mailing Address - Phone:855-722-4422
Mailing Address - Fax:
Practice Address - Street 1:301 S HEATHERWILDE BLVD # 2557
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3533
Practice Address - Country:US
Practice Address - Phone:855-722-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181116801Medicaid