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NPI Code Detail

MEDICARE: DEBORAH LILY BURROW FORTIN LCMHC

MEDICARE: DEBORAH LILY BURROW FORTIN LCMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorA15248NC
2101YM0800XMental Health CounselorA15248NC

General Provider Information

NPI Number : 1356983738
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH LILY BURROW FORTIN LCMHC
Provider Business Mailing Address
First Line : 26 BEAUMONT DR
Second Line :
City : HENDERSONVILLE
State : NC
Zip : 28739-7050
Country : US
Telephone Number : 980-428-9429
Fax Number :
Provider Business Practice Location Address
First Line : 1915 GEORGE ST
Second Line :
City : HENDERSONVILLE
State : NC
Zip : 28792-2948
Country : US
Telephone Number : 980-428-9429
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2019
Last Update Date : 04/11/2025

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