Provider Demographics
NPI:1912378381
Name:DOOLEY, DEBORAH (MFT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16493 RIO NIDO RD
Mailing Address - Street 2:
Mailing Address - City:GUERNEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95446-9565
Mailing Address - Country:US
Mailing Address - Phone:707-775-5547
Mailing Address - Fax:
Practice Address - Street 1:650 LARKFIELD CTR # A-3
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1400
Practice Address - Country:US
Practice Address - Phone:707-775-5547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 23789101Y00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor