Provider Demographics
NPI:1184792491
Name:BROWN, DEBORAH MARTIN (MA, LPC, LSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:MARTIN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LPC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6130
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-6130
Mailing Address - Country:US
Mailing Address - Phone:304-324-8106
Mailing Address - Fax:
Practice Address - Street 1:RT. 2, BLUE PRINCE ROAD
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701
Practice Address - Country:US
Practice Address - Phone:304-327-8581
Practice Address - Fax:304-327-2525
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV826101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional