Provider Demographics
NPI:1467582783
Name:VEGA-COWAN, DEBRA (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:VEGA-COWAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 RATON HWY
Mailing Address - Street 2:
Mailing Address - City:GRENVILLE
Mailing Address - State:NM
Mailing Address - Zip Code:88424-7537
Mailing Address - Country:US
Mailing Address - Phone:712-490-6651
Mailing Address - Fax:575-374-4243
Practice Address - Street 1:2301 RATON HWY
Practice Address - Street 2:
Practice Address - City:GRENVILLE
Practice Address - State:NM
Practice Address - Zip Code:88424-7537
Practice Address - Country:US
Practice Address - Phone:712-490-6651
Practice Address - Fax:575-374-4243
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE30881041C0700X
NMT-0109961101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470780489OtherMIDLANDS HEALTH
NE470780489OtherFIRST ADMINISTRATORS