Provider Demographics
NPI:1336555937
Name:DEVINCENT, DEBORAH LYNN (LCPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:DEVINCENT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 COMPTON LN
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8868
Mailing Address - Country:US
Mailing Address - Phone:410-952-9966
Mailing Address - Fax:410-552-9404
Practice Address - Street 1:1425 LIBERTY RD
Practice Address - Street 2:SUITE 206
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6420
Practice Address - Country:US
Practice Address - Phone:410-952-9966
Practice Address - Fax:410-552-9404
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6876101YP2500X, 101YA0400X, 101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLC6876OtherMARYLAND BOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS