Debra Lee Fuentes, LPCC-SUPV, LICDC-CS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E8454-SUPV Issued in OH

Practice address

36 Public SQ
Suite 202
Willoughby, OH 44094-7854

Phone

(440) 488-4081

NPI assigned

Jan 11, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: debrafuentes@tdh.allscriptsdirect.net

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.

• Fuentes Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Willoughby, OH
  • NPI 1659712859

  Professional

  NPD (past) Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1740550573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PUBLIC SQ STE 105",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947864",
            "telephone_number": "440-488-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 PUBLIC SQ",
            "address_2": "SUITE 202",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947854",
            "telephone_number": "440-488-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "DEBRA",
        "middle_name": "LEE",
        "credential": "LPCC-SUPV, LICDC-CS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "031086",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E8454-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Fried
• Friends Forever Residential Care LLC
• Carolyn Frink
• Laura Lee Frycklund, NP
• Fuentes Counseling Services
• Marketa Fuller-President
• Sonya Latrice Fuller, MSW, LISW-S
• Lisa Marie Fulton, RN
• Elena Furman, D.M.D.
• Camille Futrell

• Professional Counselor in Willoughby, OH
• Providers in Willoughby, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.