Provider Demographics
NPI:1689189144
Name:CROCETTI, DEBORAH JOAN (LMFT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JOAN
Last Name:CROCETTI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:JOAN
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:526 WOODCREEK DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-3154
Mailing Address - Country:US
Mailing Address - Phone:121-440-0968
Mailing Address - Fax:
Practice Address - Street 1:828 SHADY BROOK LN
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-7912
Practice Address - Country:US
Practice Address - Phone:214-400-9689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1661106H00000X
TX203185106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist