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NPI Code Detail

MEDICARE: DR. DEBORAH S LUNG LPC

MEDICARE:  DR. DEBORAH S LUNG  LPC
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
1101Y00000XCounselor0701002600VA
2101YM0800XMental Health Counselor0701002600VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2400231OTHERVAANTHEM BLUE CROSS BLUE SH

General Provider Information

NPI Number : 1467597641
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBORAH S LUNG LPC
Provider Business Mailing Address
First Line : 770 PETERSBURG DR
Second Line :
City : FORT MILL
State : SC
Zip : 29708-5708
Country : US
Telephone Number : 803-431-0037
Fax Number :
Provider Business Practice Location Address
First Line : 4701 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-3217
Country : US
Telephone Number : 803-431-0037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 07/03/2013

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Directions to “ DR. DEBORAH S LUNG LPC” Practice Location

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