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General NPI Number Information
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NPI Number | 1124033824
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Entity Type | Individual
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Provider Name | ROGER JOHANNES DEBEUS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 14 S PACK SQ SUITE 350
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City | ASHEVILLE
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State | NC
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Zip | 28801-3511
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Country | US
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Telephone | 828-333-5359
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Fax | 828-333-5359
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Provider Business Mailing Address
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Address Line | 3196 ARCHES BLUFF CIR
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City | LANCASTER
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State | SC
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Zip | 29720-0156
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Country | US
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Telephone | 828-782-7628
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3306
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810002866
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY004752
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License Number State | GA
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