Provider Demographics
NPI:1457532533
Name:NIGHTENGALE, DEBORAH F (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:F
Last Name:NIGHTENGALE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 OAK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-2909
Mailing Address - Country:US
Mailing Address - Phone:904-716-2739
Mailing Address - Fax:904-249-6186
Practice Address - Street 1:2275 OAK FOREST DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-2909
Practice Address - Country:US
Practice Address - Phone:904-716-2739
Practice Address - Fax:904-249-6186
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-17
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5207101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5207OtherFL LMHC