Deborah Hydrick Kirkland – Professional Counselor

Key facts

NPI: 1922337286
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: LPC005674 (GA)
Practice address: 1030 Village Dr
Watkinsville, GA 30677-6004
Phone: (706) 769-1718
Fax: (706) 769-4535
NPI assigned: Dec 16, 2009
Sex: Female
Sole proprietor: Yes

Organizations & group practices 2

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.

Douglas W Duke LPC Professional Counselor · Watkinsville, GA · NPI 1497987119

NPD (past) PROFESSIONAL
Stresscare, Inc. Clinical Social Worker · Watkinsville, GA · NPI 1023086105

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Education

State licenses

License	State	Type	Specialty
LPC005674	GA	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Stresscare, Inc.		Past	Accepting new patients
Douglas W Duke LPC	Professional	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	LPC005674	GA	Yes

Addresses

Primary practice location

1030 Village Dr
Watkinsville, GA 30677-6004

Mailing address

1030 Village Dr
Watkinsville, GA 30677-6004
Phone (706) 769-1718

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 16, 2009.

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1922337286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 VILLAGE DR",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306776004",
            "telephone_number": "706-769-1718",
            "fax_number": "706-769-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 VILLAGE DR",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306776004",
            "telephone_number": "706-769-1718",
            "fax_number": "706-769-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "DEBORAH",
        "middle_name": "HYDRICK",
        "name_prefix": "Mrs.",
        "credential": "M. ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

All providers in Watkinsville, GA · Professional Counselor in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.