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NPI Code Detail

MEDICARE: MS. DEBORAH CHELETTE - WILSON LPC

MEDICARE: MS. DEBORAH CHELETTE - WILSON 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
1101YP2500XProfessional Counselor15127TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
215127OTHERTXLICENSE NUMBER

General Provider Information

NPI Number : 1730173253
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH CHELETTE - WILSON LPC
Provider Business Mailing Address
First Line : 1804 LIVINGSTON ST
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-3724
Country : US
Telephone Number : 903-850-6334
Fax Number : 903-365-2198
Provider Business Practice Location Address
First Line : 108 WAIN DR STE B
Second Line :
City : LONGVIEW
State : TX
Zip : 75604-1231
Country : US
Telephone Number : 903-850-6334
Fax Number : 906-236-8510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 03/31/2020

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