Individual provider Active NPI

Deborah Ebener, PH.D.

  • Psychologist
  • Tallahassee, FL
National Provider Identifier
1578570909
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY5093 Issued in FL
Practice address
1114 W Call St Ste 3210
Tallahassee, FL 32306-1766
Phone
(850) 644-3611
NPI assigned
Aug 1, 2006
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5093 FL Primary
Adult Development & Aging Psychologist 103TA0700X PY5093 FL
Counseling Psychologist 103TC1900X
Clinical Child & Adolescent Psychologist 103TC2200X PY5093 FL
Intellectual & Developmental Disabilities Psychologist 103TM1800X
Rehabilitation Psychologist 103TR0400X PY5093 FL

Addresses

Primary practice location

1114 W Call St Ste 3210
Tallahassee, FL 32306-1766

Mailing address

1114 W Call St Ste 3210
Tallahassee, FL 32304-3476
Phone (850) 644-3611

Other identifiers 1

IdentifierTypeStateIssuer
59612OtherFLBLUE CROSS BLUE SHIELD

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY5093FLMDRehabilitation Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah J Ebener PHD Psychologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1578570909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 W CALL ST STE 3210",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323043476",
            "telephone_number": "850-644-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W CALL ST STE 3210",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323061766",
            "telephone_number": "850-644-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBENER",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5093",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "FL",
            "license": "PY5093",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY5093",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "FL",
            "license": "PY5093",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "59612",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.