Debora a. Kustron, Psy.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002140 Issued in CT

Legal business name

DEBORA A. KUSTRON, PSY.D., LLC

Practice address

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

Phone

(860) 683-2352

NPI assigned

Jul 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Debora A Kustron, PSY.D.NPI 1316087950

Title

Manager

Phone

(860) 683-2352

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 2

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

• Debora Ann Kustron, PSY.D.

  • Clinical Psychologist
  • Windsor, CT
  • NPI 1316087950
  Medicare reassignment NPD Authorized official
• Timothy J. Nance, PH.D.

  • Psychologist
  • Windsor, CT
  • NPI 1902939135
  NPD (past)

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1407134554",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORA A. KUSTRON, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "KUSTRON",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-683-2352",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316087950",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dawid, BCBA
• Day Hill Dental PLLC
• Francesca E Day, M.S., CCC-SLP
• Cheryl Ann Dean, LCSW
• Sonia Deandrade
• Scott R Decesare, RPH
• John J Defrancesco, PH.D.
• Ashley Del Pozo
• Laurie Delcore
• Tyler Delgaizo

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.