Provider Demographics
NPI:1790018919
Name:ANTHONY, DEBORAH ELLEN (LMHC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELLEN
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ELLEN
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6000A SAWGRASS VILLAGE CIR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32082-5011
Mailing Address - Country:US
Mailing Address - Phone:904-200-9945
Mailing Address - Fax:
Practice Address - Street 1:6000A SAWGRASS VILLAGE CIR
Practice Address - Street 2:SUITE 6
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32082-5011
Practice Address - Country:US
Practice Address - Phone:904-200-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9332101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health