Provider Demographics
NPI:1609983774
Name:DINOLFO, DEBRA ALEXANDER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ALEXANDER
Last Name:DINOLFO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:A
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 MALLARD ST
Mailing Address - Street 2:RM 245
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4046
Mailing Address - Country:US
Mailing Address - Phone:864-241-1040
Mailing Address - Fax:864-241-1124
Practice Address - Street 1:124 MALLARD ST
Practice Address - Street 2:RM 245
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4046
Practice Address - Country:US
Practice Address - Phone:864-241-1040
Practice Address - Fax:864-241-1124
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000810101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC301100Medicaid
SC301100Medicaid