Provider Demographics
NPI:1811400468
Name:DEBORD, CARRIE LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:DEBORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7251 SAWMILL RD.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016
Mailing Address - Country:US
Mailing Address - Phone:614-766-0161
Mailing Address - Fax:614-766-0298
Practice Address - Street 1:1434 N. COURT ST.
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113
Practice Address - Country:US
Practice Address - Phone:614-766-0161
Practice Address - Fax:614-766-0298
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1300434101YM0800X
OHC1300434101YP2500X
OHE.2202750101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health