Provider Demographics
NPI:1427029230
Name:BYRD, DEBORAH LYNN (LCSW,LPC)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNN
Last Name:BYRD
Suffix:
Gender:F
Credentials:LCSW,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5722 ECHOWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-1418
Mailing Address - Country:US
Mailing Address - Phone:210-967-4045
Mailing Address - Fax:210-967-4046
Practice Address - Street 1:5722 ECHOWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-1418
Practice Address - Country:US
Practice Address - Phone:210-967-4045
Practice Address - Fax:210-967-4046
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014284101YM0800X
MO2005002429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S78BMedicare ID - Type Unspecified