Individual provider Active NPI

Deborah Leslie Kos, PSY.D.

  • Prescribing (Medical) Psychologist
  • Albuquerque, NM
National Provider Identifier
1477585990
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
0042C Issued in NM
Practice address
4810 Hardware Dr NE
Albuquerque, NM 87109-2013
Phone
(505) 273-4610
Fax
(505) 255-4717
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) Psychologist 103TP0016X 0042C NM Primary

Addresses

Primary practice location

4810 Hardware Dr NE
Albuquerque, NM 87109-2013

Mailing address

4810 Hardware Dr NE Ste 1
Albuquerque, NM 87109-2013
Phone (505) 289-1392

Other identifiers 2

IdentifierTypeStateIssuer
1149OtherNMPSYCHOLOGY LICENSE
13870068MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0042CNMMDPrescribing (Medical) Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1477585990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 HARDWARE DR NE STE 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092013",
            "telephone_number": "505-289-1392",
            "fax_number": "855-929-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 HARDWARE DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092013",
            "telephone_number": "505-273-4610",
            "fax_number": "505-255-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOS",
        "first_name": "DEBORAH",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "0042C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE",
            "identifier": "1149",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13870068",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.