Provider Demographics
NPI:1336755198
Name:ADAMS, DEBORAH MAE (MA, CPC, PCCT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:MAE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA, CPC, PCCT
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 956971
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30095-9517
Mailing Address - Country:US
Mailing Address - Phone:404-519-8773
Mailing Address - Fax:
Practice Address - Street 1:1631 BENTWOOD DR SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-4507
Practice Address - Country:US
Practice Address - Phone:404-519-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10184220101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral