Provider Demographics
NPI:1174691950
Name:GION, DEBRA SUSKIN (LPC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:SUSKIN
Last Name:GION
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:SUSKIN
Other - Last Name:WINGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 12706
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-0046
Mailing Address - Country:US
Mailing Address - Phone:520-858-6262
Mailing Address - Fax:480-839-0197
Practice Address - Street 1:21300 N JOHN WAYNE PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-8979
Practice Address - Country:US
Practice Address - Phone:520-858-6262
Practice Address - Fax:480-839-0197
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-#0277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ931081OtherAHCCCS PROVIDER ID