MEDICARE: DEBORAH LORENE VAN WIEREN LCMHC, LCAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	11549	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	22205	NC

General Provider Information

NPI Number	:	1790147890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH LORENE VAN WIEREN LCMHC, LCAS

Provider Business Mailing Address
First Line	:	PO BOX 2272
Second Line	:
City	:	HENDERSONVILLE
State	:	NC
Zip	:	28793-2272
Country	:	US
Telephone Number	:	828-692-7300
Fax Number	:	828-692-7710

Provider Business Practice Location Address
First Line	:	475 S CHURCH ST STE S102
Second Line	:
City	:	HENDERSONVILLE
State	:	NC
Zip	:	28792-5260
Country	:	US
Telephone Number	:	828-692-7300
Fax Number	:	828-692-7710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	01/15/2026

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