Provider Demographics
NPI:1962266841
Name:WARNER, DEBORAH LAURENE (LAC/LPC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LAURENE
Last Name:WARNER
Suffix:
Gender:F
Credentials:LAC/LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W CALLE DE ARCOS
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3034
Mailing Address - Country:US
Mailing Address - Phone:301-706-4398
Mailing Address - Fax:
Practice Address - Street 1:625 N GILBERT RD STE 204
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-4724
Practice Address - Country:US
Practice Address - Phone:480-477-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-19615101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health