Active NPI
Debora Rose Luczywek, L.P.C.C.
- Mental Health Counselor
- Thousand Oaks, CA
National Provider Identifier
1104378082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPCC1785
- Practice address
- 125 W Thousand Oaks Blvd Ste 500
Thousand Oaks, CA 91360-4462 - Phone
- (805) 777-3518
- NPI assigned
- Oct 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPCC1785 | CA | Primary |
Addresses
Primary practice location
125 W Thousand Oaks Blvd Ste 500
Thousand Oaks, CA 91360-4462
Mailing address
305 Longbranch Rd
Simi Valley, CA 93065-5324
Phone (805) 551-6219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250509001188 | CA | Practitioner - Mental Health Counselor | 6608393970 | Practice locations: Simi Valley, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
Simi Valley, CA 93065
Phone (805) 551-6219
305 Longbranch Rd
Simi Valley, CA 93065-5324
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC1785 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477440000000",
"number": "1104378082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 LONGBRANCH RD",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930655324",
"telephone_number": "805-551-6219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W THOUSAND OAKS BLVD STE 500",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913604462",
"telephone_number": "805-777-3518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCZYWEK",
"first_name": "DEBORA",
"middle_name": "ROSE",
"name_prefix": "Dr.",
"credential": "L.P.C.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-26",
"last_updated": "2016-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "LPCC1785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.