Provider Demographics
NPI:1285402354
Name:ACEVEDO, DEBBIE (MS, LMHC)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 NE 21ST AVE # 11
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5690
Mailing Address - Country:US
Mailing Address - Phone:954-842-5440
Mailing Address - Fax:
Practice Address - Street 1:2881 E OAKLAND PARK BLVD # 404
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1813
Practice Address - Country:US
Practice Address - Phone:954-600-1576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health