Deborah Kathryn Elliott-Desorbo, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-3210 Issued in CO

Practice address

6455 N Union Blvd
Suite 103
Colorado Springs, CO 80918-5852

Phone

(719) 332-5177

NPI assigned

Aug 31, 2006

Last updated

Jun 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Deborah Kathryn Elliott Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

George Washington University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St. Louis Behavioral Medicine Institute IncGroup PAC ID 3173428638, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Louis Behavioral Medicine Institute Inc

  • Psychologist
  • Saint Louis, MO
  • NPI 1487732335
  Medicare reassignment Care Compare group NPD
• Deb Elliott-Desorbo, PH.D., LLC

  • Clinical Psychologist
  • Colorado Springs, CO
  • NPI 1013147636
  Authorized official Same address or phone
• St. Louis Behavioral Medicine Institute Inc

  dba St Louis Behavioral Medicine Institute

  • Mental Health Counselor
  • Fairview Heights, IL
  • NPI 1952169179
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1255442612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62342",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809622342",
            "telephone_number": "719-332-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6455 N UNION BLVD",
            "address_2": "SUITE 103",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185852",
            "telephone_number": "719-332-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT-DESORBO",
        "first_name": "DEBORAH",
        "middle_name": "KATHRYN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY-3210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "ELLIOTT",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayla Elling
• Venessa Ellington Alston, LAC, LCSW
• Ellington Eyecare PLLC
• Jasmine Ellington
• Elliott Chiropractic Center L.L.C.
• Alexandra Elliott, CRNA
• Ashley Brook Elliott, BCBA
• Brian Elliott, D.D.S.
• Christina Renee Elliott, ANP
• Dee Ann Elliott, D.C.

• Clinical Psychologist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.

Verify at the official NPI Registry.