Provider Demographics
NPI:1699829598
Name:ENNIS, DEBORAH L (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:L
Last Name:ENNIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-1704
Mailing Address - Country:US
Mailing Address - Phone:508-432-3383
Mailing Address - Fax:
Practice Address - Street 1:165 ROUTE 6A
Practice Address - Street 2:COUNSELING ASSOCIATES
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02645
Practice Address - Country:US
Practice Address - Phone:508-432-3383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health