Deborah a Odonnell, PHD, Clinical Psychologist, LLC

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

03958 Issued in MD

Legal business name

DEBORAH A ODONNELL, PHD, CLINICAL PSYCHOLOGIST, LLC

Practice address

41660 Courthouse Dr # 201C
Leonardtown, MD 20650-3887

Phone

(240) 587-0457

Fax

(301) 475-8810

NPI assigned

Jul 22, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Deborah A O'Donnell, PHDNPI 1679701866

Title

Owner, Clinical Psychologist

Phone

(240) 587-0457

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

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

• Deborah A O'Donnell, PHD

  • Clinical Child & Adolescent Psychologist
  • Lexington Park, MD
  • NPI 1679701866
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1477938215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1212",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206501212",
            "telephone_number": "240-587-0457",
            "fax_number": "301-475-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41660 COURTHOUSE DR # 201C",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503887",
            "telephone_number": "240-587-0457",
            "fax_number": "301-475-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH A ODONNELL, PHD, CLINICAL PSYCHOLOGIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER, CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "240-587-0457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "03958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Leonardtown, MD
• Providers in Leonardtown, MD by specialty
• Clinical Child & Adolescent Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.