Individual provider Active NPI

Deborah A Koricke, PH.D.

  • Clinical Psychologist
  • Rocky River, OH
National Provider Identifier
1598779092
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3304 Issued in OH
Practice address
20800 Center Ridge Rd Ste 100
Rocky River, OH 44116-4306
Phone
(440) 333-4949
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3304 OH Primary

Addresses

Primary practice location

20800 Center Ridge Rd Ste 100
Rocky River, OH 44116-4306

Mailing address

20800 Center Ridge Rd Ste 100
Rocky River, OH 44116-4306
Phone (440) 333-4949

Other identifiers 2

IdentifierTypeStateIssuer
0704250MedicaidOH
0413292MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090826000100 OH Practitioner - Clinical Psychologist 2961557095 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deer Oaks Mental Health Associates PCGroup PAC ID 2264337013, 55 clinicians

Practice addresses (Care Compare)

5200 Marymount Village Dr
Garfield Heights, OH 44125-2973
Phone (888) 365-6271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3304OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Mental Health Associates PC Clinical CurrentSince Nov 1, 2025 Accepting new patients
Center for Effective Living Inc. Past Accepting new patients
Deborah Koricke, PHD and Associates, LLC Clinical Past Accepting new patients

Locations

5200 Marymount Village Dr
Garfield Heights, OH 44125
Phone (216) 332-1070

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1598779092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20800 CENTER RIDGE RD STE 100",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441164306",
            "telephone_number": "440-333-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20800 CENTER RIDGE RD STE 100",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441164306",
            "telephone_number": "440-333-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORICKE",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0704250",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0413292",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

Verify at the official NPI Registry.