Healthcare Provider Details

I. General information

NPI: 1184643298
Provider Name (Legal Business Name): DEBORAH ANN TIMPERIO LMHC, MAC, CAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/20/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAHC-VICENZA UNIT 31403
APO AE
09630
US

IV. Provider business mailing address

CMR 427 BOX 383
APO AE
09630-0004
US

V. Phone/Fax

Practice location:
  • Phone: 314-636-9601
  • Fax:
Mailing address:
  • Phone: 349-808-9509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC-4514
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number507584
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: