Basic Information
Provider Information
NPI: 1154791291
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGLETON
FirstName: DEBHORA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC-S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14099 TWIN LAKES DR
Address2:  
City: PRAIRIEVILLE
State: LA
PostalCode: 707694439
CountryCode: US
TelephoneNumber: 2259269706
FaxNumber: 2259269708
Practice Location
Address1: 8706 JEFFERSON HWY STE A
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708092233
CountryCode: US
TelephoneNumber: 2259269706
FaxNumber: 2259269708
Other Information
ProviderEnumerationDate: 10/01/2015
LastUpdateDate: 09/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X1014LAN Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
101YP2500X2954LAY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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