Provider Demographics
NPI:1093697716
Name:SCRIMO, DEBORAH NOEL (LPC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:NOEL
Last Name:SCRIMO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 HUNTERS TRCE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-9427
Mailing Address - Country:US
Mailing Address - Phone:770-324-7734
Mailing Address - Fax:
Practice Address - Street 1:110 EVANS MILL DR STE 306
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1623
Practice Address - Country:US
Practice Address - Phone:770-324-7734
Practice Address - Fax:770-324-7734
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty