Provider Demographics
NPI:1972667194
Name:MAXEY, DEBORAH M (PHD LPC LMFT)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:M
Last Name:MAXEY
Suffix:
Gender:F
Credentials:PHD LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 LEESVILLE ROAD
Mailing Address - Street 2:PEACHTREE COUNSELING CENTER INC
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502
Mailing Address - Country:US
Mailing Address - Phone:434-239-1928
Mailing Address - Fax:434-239-8779
Practice Address - Street 1:798 LEESVILLE ROAD
Practice Address - Street 2:PEACHTREE COUNSELING CENTER INC
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502
Practice Address - Country:US
Practice Address - Phone:434-239-1928
Practice Address - Fax:434-239-8779
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002521101Y00000X
VA0717000206106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2030554OtherCIGNA
VA242399OtherBLUE CROSS BS