Provider Demographics
NPI:1487999736
Name:COUCH, DEANA JUDITH (CRC, LPCC-S)
Entity type:Individual
Prefix:MS
First Name:DEANA
Middle Name:JUDITH
Last Name:COUCH
Suffix:
Gender:F
Credentials:CRC, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:OH
Mailing Address - Zip Code:43569-0055
Mailing Address - Country:US
Mailing Address - Phone:419-936-7744
Mailing Address - Fax:
Practice Address - Street 1:13172 MAIN ST # 55
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:OH
Practice Address - Zip Code:43569-9990
Practice Address - Country:US
Practice Address - Phone:419-806-5688
Practice Address - Fax:419-754-2609
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401223497101YP2500X
00094728225C00000X
OHE-2001973-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor