Provider Demographics
NPI:1972128502
Name:CHINANA, DEBORAH (LPC-IT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:CHINANA
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 MAIN ST.
Mailing Address - Street 2:ST 21, 3RD FLOOR
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54302
Mailing Address - Country:US
Mailing Address - Phone:920-360-0695
Mailing Address - Fax:
Practice Address - Street 1:1234 MAIN ST.
Practice Address - Street 2:ST 21, 3RD FLOOR
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54302-5430
Practice Address - Country:US
Practice Address - Phone:920-360-0695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health