NPIMap

Organization Active NPI

Deborah Koricke, PHD and Associates, LLC

  • Clinical Psychologist
  • Rocky River, OH
National Provider Identifier
1548400583
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3304 Issued in OH
Legal business name
DEBORAH KORICKE, PHD AND ASSOCIATES, LLC
Practice address
20800 Center Ridge Rd Ste 105
Rocky River, OH 44116-4314
Phone
(440) 333-4949
Fax
(440) 333-5044
NPI assigned
Mar 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Dr. Deborah Koricke, PHDNPI 1598779092
Title
Owner
Phone
(440) 333-4949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X E0001805 OH
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 3304 OH Primary

Addresses

Primary practice location

20800 Center Ridge Rd Ste 105
Rocky River, OH 44116-4314

Mailing address

20800 Center Ridge Rd Ste 105
Rocky River, OH 44116-4314
Phone (440) 333-4949

Other identifiers 1

IdentifierTypeStateIssuer
0704250MedicaidOH

National Provider Directory

National Provider Directory

Locations

20800 Center Ridge Rd
Ste 105
Rocky River, OH 44116
Phone (440) 333-4949

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1548400583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20800 CENTER RIDGE RD STE 105",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441164314",
            "telephone_number": "440-333-4949",
            "fax_number": "440-333-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20800 CENTER RIDGE RD STE 105",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441164314",
            "telephone_number": "440-333-4949",
            "fax_number": "440-333-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH KORICKE, PHD AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "KORICKE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-333-4949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0001805",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0704250",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.