Provider Demographics
NPI:1053565481
Name:PONTON, DEBORAH DIMMITT (LSCSW, LCAC)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:DIMMITT
Last Name:PONTON
Suffix:
Gender:F
Credentials:LSCSW, LCAC
Other - Prefix:
Other - First Name:DEBBY
Other - Middle Name:
Other - Last Name:DIMMITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1005 N BUCKEYE AVE
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-1940
Mailing Address - Country:US
Mailing Address - Phone:785-236-8612
Mailing Address - Fax:785-783-5366
Practice Address - Street 1:1005 N. BUCKEYE
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410
Practice Address - Country:US
Practice Address - Phone:785-341-7931
Practice Address - Fax:785-823-3109
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS41311041C0700X
KSLMSW 60911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical