Provider Demographics
NPI:1861410912
Name:PETERS, DEBRA KAY (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:KAY
Last Name:PETERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEBRA
Other - Middle Name:PETERS
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:220 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3764
Mailing Address - Country:US
Mailing Address - Phone:828-475-6544
Mailing Address - Fax:828-475-6545
Practice Address - Street 1:220 W UNION ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3764
Practice Address - Country:US
Practice Address - Phone:828-475-6544
Practice Address - Fax:828-475-6545
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2137103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6001300Medicaid
NC2818209BMedicare PIN