Provider Demographics
NPI:1194427047
Name:HENNESSEE, DEBORAH A (MA, LMFT, LPCC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:HENNESSEE
Suffix:
Gender:F
Credentials:MA, LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16450 LOS GATOS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-5594
Mailing Address - Country:US
Mailing Address - Phone:408-645-5540
Mailing Address - Fax:
Practice Address - Street 1:16450 LOS GATOS BLVD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-5594
Practice Address - Country:US
Practice Address - Phone:408-645-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11458101YP2500X
CA132600106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional