Provider Demographics
NPI:1609254598
Name:ZUMWALT, DEB (MA, LPC, NCC, CPT)
Entity Type:Individual
Prefix:
First Name:DEB
Middle Name:
Last Name:ZUMWALT
Suffix:
Gender:F
Credentials:MA, LPC, NCC, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7815 HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66227-2406
Mailing Address - Country:US
Mailing Address - Phone:913-276-4673
Mailing Address - Fax:
Practice Address - Street 1:115 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-1348
Practice Address - Country:US
Practice Address - Phone:913-276-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional