Provider Demographics
NPI:1861582538
Name:MARLIN, DEBORAH SUE (LPC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUE
Last Name:MARLIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:SUE
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:BANGS
Mailing Address - State:TX
Mailing Address - Zip Code:76823-0298
Mailing Address - Country:US
Mailing Address - Phone:325-642-8589
Mailing Address - Fax:
Practice Address - Street 1:1081 COUNTY ROAD 102
Practice Address - Street 2:
Practice Address - City:SANTA ANNA
Practice Address - State:TX
Practice Address - Zip Code:76878-5101
Practice Address - Country:US
Practice Address - Phone:325-642-8589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09663101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6149LCOtherBLUE CROSS BLUE SHIELD
TX09663OtherLPC LICENSE