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General NPI Number Information
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NPI Number | 1710069976
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Entity Type | Individual
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Provider Name | DEBORAH JANE DEVLIN LSW, LPCC
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 246 NORTHLAND DR
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City | MEDINA
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State | OH
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Zip | 44256-3441
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Country | US
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Telephone | 330-725-9195
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Fax |
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Provider Business Mailing Address
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Address Line | 179 HUNT CLUB DR
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City | COPLEY
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State | OH
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Zip | 44321-2735
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Country | US
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Telephone | 330-212-4876
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Fax | 330-633-4294
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E0004001
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | S.0017293
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License Number State |
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