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Contact Information

DELTON W DE VOSE, PHD, LPCS, CCS, BCTM
4210 COLUMBIA RD STE 11B
MARTINEZ, GA30907-0443
 Phone: 706-364-6576
 Fax: 888-445-2452
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for DELTON W DE VOSE · (Male)

NPI Number 1194860759
Status Active
Credentials PHD, LPCS, CCS, BCTM
Entity Individual
Enumeration date 02/21/2007
Last updated 09/16/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 007674
  • NC License # 1658
  • NC License # 4985
  • NC Medicaid 6103058
  • Other 3404922 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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