Individual
DEBRA K MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
352 LANTANA RD, CROSSVILLE, TN 38555-4900
(931) 707-8200
Mailing address
352 LANTANA RD, CROSSVILLE, TN 38555-4900
(931) 707-8200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
05938
TN
101YP2500X
Professional Counselor
PC005461
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056845
GROUP PROVIDER NUMBER
PA
Enumeration date
03/31/2010
Last updated
11/03/2022
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