Provider Demographics
NPI:1154350486
Name:BRANTLEY, DEBRA K (LPC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:K
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEB
Other - Middle Name:
Other - Last Name:BRANTLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1309 W PINE AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-4263
Mailing Address - Country:US
Mailing Address - Phone:580-255-7460
Mailing Address - Fax:580-255-7675
Practice Address - Street 1:1309 W PINE AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-4263
Practice Address - Country:US
Practice Address - Phone:580-255-7460
Practice Address - Fax:580-255-7675
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health