Provider Demographics
NPI:1992216071
Name:DEBOARD, LEAH BETH (LPC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:BETH
Last Name:DEBOARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:BETH
Other - Last Name:DEBOARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6906 FREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-6221
Mailing Address - Country:US
Mailing Address - Phone:806-790-8187
Mailing Address - Fax:
Practice Address - Street 1:6906 FREEMONT AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413
Practice Address - Country:US
Practice Address - Phone:806-790-8187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63721101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional