Organization Active NPI

Engelbrecht Psychological Services LLC

  • Psychologist
  • Blue Springs, MO
National Provider Identifier
1306091038
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1263 Issued in MO
Legal business name
ENGELBRECHT PSYCHOLOGICAL SERVICES LLC
Practice address
1201 NW North Ridge Dr # D
Blue Springs, MO 64015-6389
Phone
(816) 229-6177
NPI assigned
Nov 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Dr. Deborah Engelbrecht, MS, PH.D.NPI 1265462204
Title
Psychologist
Phone
(816) 229-6177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 1263 MO Primary

Addresses

Primary practice location

1201 NW North Ridge Dr # D
Blue Springs, MO 64015-6389

Mailing address

1201 NW North Ridge Dr # D
Blue Springs, MO 64015-6389
Phone (816) 229-6177

Other identifiers 1

IdentifierTypeStateIssuer
493376305MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090211000044 MO Part B Supplier - Clinic/Group Practice 4688739568 Receives reassigned benefits from 1 practitioner
Practice locations: Lees Summit, MO

National Provider Directory

National Provider Directory

Locations

1201 NW North Ridge Dr
Ste D
Blue Springs, MO 64015
Phone (816) 228-9811

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1306091038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 NW NORTH RIDGE DR # D",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640156389",
            "telephone_number": "816-229-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NW NORTH RIDGE DR # D",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640156389",
            "telephone_number": "816-229-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGELBRECHT PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-21",
        "last_updated": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "ENGELBRECHT",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "816-229-6177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MS, PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MO",
            "license": "1263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493376305",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.