Provider Demographics
NPI:1912393158
Name:FUJAN-PINNEY, DEBORAH L (LPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:FUJAN-PINNEY
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 1:623 MOUNT ALBERT WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7915
Mailing Address - Country:US
Mailing Address - Phone:678-472-2608
Mailing Address - Fax:
Practice Address - Street 1:915 INTERSTATE RIDGE DR
Practice Address - Street 2:G
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-7076
Practice Address - Country:US
Practice Address - Phone:678-207-2931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007301101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor