Provider Demographics
NPI:1760734107
Name:BARAN, DEBRA (LCPC, CADC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:BARAN
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-1612
Mailing Address - Country:US
Mailing Address - Phone:847-309-6438
Mailing Address - Fax:
Practice Address - Street 1:9 CRYSTAL LAKE RD STE 240
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-1296
Practice Address - Country:US
Practice Address - Phone:847-309-6438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL18677101YA0400X
IL180001384101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)