Debora Ann Kustron, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002140 Issued in CT

Practice address

61 Bloomfield Ave
2ND Floor
Windsor, CT 06095-2809

Phone

(860) 683-2352

Fax

(860) 683-2352

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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 and National Provider Directory roles.

• Debora a. Kustron, Psy.D., LLC

  • Clinical Psychologist
  • Windsor, CT
  • NPI 1407134554
  Medicare reassignment NPD Authorized official
• Spectrum Psychotherapy Centers, LLC

  • Clinical Psychologist
  • Windsor, CT
  • NPI 1295748689
  NPD

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1316087950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 BLOOMFIELD AVE",
            "address_2": "2ND FLOOR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952809",
            "telephone_number": "860-683-2352",
            "fax_number": "860-683-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BLOOMFIELD AVE",
            "address_2": "2ND FLOOR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952809",
            "telephone_number": "860-683-2352",
            "fax_number": "860-683-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSTRON",
        "first_name": "DEBORA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "002140",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "002140",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Kopcza
• Ksy Home LLC
• Vincent Kuchipudi
• Ananya Kumar
• Krista Kuntz
• Lasha Laggis, PSYD.
• Susan Pomeroy Lamanis
• Samantha Landry
• Susan Lane
• Jordan Lang

• Clinical Psychologist in Windsor, CT
• Providers in Windsor, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.