Provider Demographics
NPI:1144434416
Name:WILLIS, DEBRA JANE (LPC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:JANE
Last Name:WILLIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:JANE
Other - Last Name:CHITWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1815 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-7870
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-336-1339
Practice Address - Street 1:1815 PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72405-7870
Practice Address - Country:US
Practice Address - Phone:870-933-6886
Practice Address - Fax:870-336-1339
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional