Provider Demographics
NPI:1679636062
Name:KOUNTZ, DEBRA D (BSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:D
Last Name:KOUNTZ
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 MARKET ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1730
Mailing Address - Country:US
Mailing Address - Phone:415-597-8000
Mailing Address - Fax:415-597-8004
Practice Address - Street 1:939 MARKET ST. FL 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2603
Practice Address - Country:US
Practice Address - Phone:415-597-8000
Practice Address - Fax:415-597-8004
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health