Provider Demographics
NPI:1922751551
Name:JOST-BEAUFORD, DEBORAH MARIE (LCPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MARIE
Last Name:JOST-BEAUFORD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:MARIE
Other - Last Name:BEAUFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:8822 MAJOR AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2530
Mailing Address - Country:US
Mailing Address - Phone:847-331-6560
Mailing Address - Fax:
Practice Address - Street 1:8822 MAJOR AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2530
Practice Address - Country:US
Practice Address - Phone:847-331-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional