Provider Demographics
NPI:1275787921
Name:JETT, DEBORAH F (LPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:F
Last Name:JETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4502
Mailing Address - Country:US
Mailing Address - Phone:775-225-0077
Mailing Address - Fax:
Practice Address - Street 1:160 JAKE HALL RD
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-8557
Practice Address - Country:US
Practice Address - Phone:775-225-0077
Practice Address - Fax:833-233-3054
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004341101YM0800X, 103TP2701X, 106H00000X
WALH61503090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist