Provider Demographics
NPI:1104846716
Name:DOUBLIN, DEBORAH LYNN (LCSW, LMFT)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNN
Last Name:DOUBLIN
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON ST
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-6955
Mailing Address - Country:US
Mailing Address - Phone:318-325-8782
Mailing Address - Fax:318-325-8749
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:SUITE B-2
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6955
Practice Address - Country:US
Practice Address - Phone:318-325-8782
Practice Address - Fax:318-325-8749
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA51831041C0700X
LA787106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA15198674Medicaid
LA15198674Medicaid