Healthcare Provider Details

I. General information

NPI: 1689306581
Provider Name (Legal Business Name): DEBORAH A PIEZ LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 PHILOSOPHERS TER
CHESTERTOWN MD
21620-1612
US

IV. Provider business mailing address

126 PHILOSOPHERS TER
CHESTERTOWN MD
21620-1612
US

V. Phone/Fax

Practice location:
  • Phone: 443-215-5353
  • Fax: 833-615-2165
Mailing address:
  • Phone: 443-215-5353
  • Fax: 833-615-2165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC11155
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC11155
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: