Healthcare Provider Details

I. General information

NPI: 1003069451
Provider Name (Legal Business Name): DEBORAH C HALPERN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2008
Last Update Date: 11/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 HALO PINES TERRACE
ANGEL FIRE NM
87710-0026
US

IV. Provider business mailing address

PO BOX 26
ANGEL FIRE NM
87710-0026
US

V. Phone/Fax

Practice location:
  • Phone: 575-377-2514
  • Fax: 575-377-1569
Mailing address:
  • Phone: 575-377-2514
  • Fax: 575-377-1569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1025
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: