Provider Demographics
NPI:1053592113
Name:LOYD, DEBRA SUE (LPC)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:SUE
Last Name:LOYD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-4019
Mailing Address - Country:US
Mailing Address - Phone:503-325-6445
Mailing Address - Fax:
Practice Address - Street 1:1140 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-4019
Practice Address - Country:US
Practice Address - Phone:503-325-6445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1702101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional