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General NPI Number Information
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NPI Number | 1528690427
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Entity Type | Individual
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Provider Name | DEBORAH LEWIS VANDERKINTER LPC, SAC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2020
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 1519 E WASHINGTON ST STE A
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City | WEST BEND
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State | WI
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Zip | 53095-2615
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Country | US
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Telephone | 262-346-4700
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Fax |
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Provider Business Mailing Address
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Address Line | N170W20265 HUNTERS RD
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City | JACKSON
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State | WI
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Zip | 53037-9422
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Country | US
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Telephone | 920-360-9619
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 16396-131
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7596-125
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License Number State | WI
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