Provider Demographics
NPI:1538410196
Name:POWERS NEIGHBORS, DEBORAH JO (LMFT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JO
Last Name:POWERS NEIGHBORS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24526 SUNSHINE DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-7826
Mailing Address - Country:US
Mailing Address - Phone:949-249-8888
Mailing Address - Fax:949-249-2929
Practice Address - Street 1:26461 CROWN VALLEY PKWY
Practice Address - Street 2:100
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6377
Practice Address - Country:US
Practice Address - Phone:949-249-8888
Practice Address - Fax:949-249-2929
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA52958106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA461932259OtherFEDERAL TAX ID NUMBER