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General NPI Number Information
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NPI Number | 1760913909
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Entity Type | Organization
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Legal Business Name | DEBORAH BASEDOW COUNSELING
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 911 S PARSONS AVE SUITE A
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City | BRANDON
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State | FL
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Zip | 33511-6070
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Country | US
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Telephone | 727-698-1806
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Fax | 813-902-6081
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Provider Business Mailing Address
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Address Line | 2729 STONEWOOD DR
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City | LAKELAND
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State | FL
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Zip | 33810-4015
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Country | US
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Telephone | 727-698-1806
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Fax | 813-902-6081
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | DEBORAH LYNN BASEDOW
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Credential | LMHC NCC
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Telephone | 727-698-1806
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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 | MH9680
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License Number State | FL
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