Provider Demographics
NPI:1770307035
Name:CARLTON, DEBORAH LYNN (LCDC, LPCA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:CARLTON
Suffix:
Gender:F
Credentials:LCDC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 AYLOR RD
Mailing Address - Street 2:
Mailing Address - City:WALLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77485-1204
Mailing Address - Country:US
Mailing Address - Phone:346-213-5901
Mailing Address - Fax:
Practice Address - Street 1:2548 AYLOR RD
Practice Address - Street 2:
Practice Address - City:WALLIS
Practice Address - State:TX
Practice Address - Zip Code:77485-1204
Practice Address - Country:US
Practice Address - Phone:346-213-5901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92259101YP2500X
TX13577101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)