Provider Demographics
NPI:1750173795
Name:SHIMBERG, DEBORAH C (LPC001621)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:SHIMBERG
Suffix:
Gender:F
Credentials:LPC001621
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3094 STRATFORD GREEN LN
Mailing Address - Street 2:
Mailing Address - City:AVONDALE ESTATES
Mailing Address - State:GA
Mailing Address - Zip Code:30002-1339
Mailing Address - Country:US
Mailing Address - Phone:404-655-5592
Mailing Address - Fax:
Practice Address - Street 1:3094 STRATFORD GREEN LN
Practice Address - Street 2:
Practice Address - City:AVONDALE ESTATES
Practice Address - State:GA
Practice Address - Zip Code:30002-1339
Practice Address - Country:US
Practice Address - Phone:404-655-5592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health