Provider Demographics
NPI:1013444678
Name:HUNTINGTON, DEBORAH DAWN (LPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:DAWN
Last Name:HUNTINGTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:DAWN
Other - Last Name:COLWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:11033 W HAZELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-6394
Mailing Address - Country:US
Mailing Address - Phone:303-596-1931
Mailing Address - Fax:
Practice Address - Street 1:11033 W HAZELWOOD DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-6394
Practice Address - Country:US
Practice Address - Phone:303-596-1931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014436101YM0800X
CO0014426101YM0800X
ID7290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000957957Medicaid
CO9000158863Medicaid