Individual provider Active NPI

Deborah Lily Burrow Fortin, LCMHC

  • Mental Health Counselor
  • Hendersonville, NC
National Provider Identifier
1356983738
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A15248 Issued in NC
Practice address
1915 George St
Hendersonville, NC 28792-2948
Phone
(980) 428-9429
NPI assigned
Oct 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A15248 NC
Mental Health Counselor 101YM0800X A15248 NC Primary

Addresses

Primary practice location

1915 George St
Hendersonville, NC 28792-2948

Mailing address

26 Beaumont Dr
Hendersonville, NC 28739-7050
Phone (980) 428-9429

Other names 1

  • Lily Fortin Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250418001129 NC Practitioner - Mental Health Counselor 7517482870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Full Circle CommunityGroup PAC ID 8022540467, 4 clinicians

Practice addresses (Care Compare)

1915 George St
Hendersonville, NC 28792-2948
Phone (828) 222-0401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A15248NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Community Mental Health CurrentSince Mar 24, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1356983738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 BEAUMONT DR",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287397050",
            "telephone_number": "980-428-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 GEORGE ST",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287922948",
            "telephone_number": "980-428-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROW FORTIN",
        "first_name": "DEBORAH",
        "middle_name": "LILY",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A15248",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILY",
            "last_name": "FORTIN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hendersonville, NC

Sources for this page

Verify at the official NPI Registry.