Provider Demographics
NPI:1790815488
Name:GOODWIN-BOND, DEBORAH YVONNE (MS, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:YVONNE
Last Name:GOODWIN-BOND
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WEST SCOTLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-6726
Mailing Address - Country:US
Mailing Address - Phone:817-271-8407
Mailing Address - Fax:
Practice Address - Street 1:320 DECKER DR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-8162
Practice Address - Country:US
Practice Address - Phone:972-739-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional