Provider Demographics
NPI:1174760847
Name:PINCKNEY, DEBORAH ELAINE (MSED,PC,LCDCIII)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELAINE
Last Name:PINCKNEY
Suffix:
Gender:F
Credentials:MSED,PC,LCDCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91132
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-7132
Mailing Address - Country:US
Mailing Address - Phone:614-258-4496
Mailing Address - Fax:
Practice Address - Street 1:189 N 20TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1550
Practice Address - Country:US
Practice Address - Phone:614-258-4496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0700473101YP2500X
OH081249101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)