Provider Demographics
NPI:1639537772
Name:FLERLAGE, DEBRA CORINE (LCPC, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:CORINE
Last Name:FLERLAGE
Suffix:
Gender:F
Credentials:LCPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:MD
Mailing Address - Zip Code:20627-0091
Mailing Address - Country:US
Mailing Address - Phone:240-309-2844
Mailing Address - Fax:
Practice Address - Street 1:39705 LADY BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2529
Practice Address - Country:US
Practice Address - Phone:240-309-2844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA2252101YA0400X
MDLC6980101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD105519400Medicaid