Provider Demographics
NPI:1841440195
Name:LINK, DEBORAH CARALEE (MA LMFT LPCC)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:CARALEE
Last Name:LINK
Suffix:
Gender:F
Credentials:MA LMFT LPCC
Other - Prefix:MISS
Other - First Name:DEBORAH
Other - Middle Name:CARALEE
Other - Last Name:SULLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20980 ROGERS DR
Mailing Address - Street 2:STE 400
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-4652
Mailing Address - Country:US
Mailing Address - Phone:763-244-4900
Mailing Address - Fax:
Practice Address - Street 1:20980 ROGERS DR
Practice Address - Street 2:STE 400
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4652
Practice Address - Country:US
Practice Address - Phone:763-244-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLPCCCC00085101YP2500X
MNLMFT1986106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1841440195Medicaid