Individual provider Active NPI

Deborah Lynn Kaegebein, PH.D.

  • Psychologist
  • Harvard, MA
National Provider Identifier
1528382124
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3308 Issued in MA
Practice address
15A Trail Ridge Way
Harvard, MA 01451-1463
Phone
(617) 519-9377
NPI assigned
Mar 25, 2010
Last updated
Jun 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3308 MA Primary

Addresses

Primary practice location

15A Trail Ridge Way
Harvard, MA 01451-1463

Mailing address

15A Trail Ridge Way
Harvard, MA 01451-1463
Phone (617) 519-9377

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3308MAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1528382124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15A TRAIL RIDGE WAY",
            "city": "HARVARD",
            "state": "MA",
            "postal_code": "014511463",
            "telephone_number": "617-519-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15A TRAIL RIDGE WAY",
            "city": "HARVARD",
            "state": "MA",
            "postal_code": "014511463",
            "telephone_number": "617-519-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAEGEBEIN",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvard, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.