Deborah Susan Kroll, PH.D., ED.S., L.P.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

AK 552 Issued in AK

Practice address

17615 Lacey Dr
Eagle River, AK 99577-8207

Phone

(907) 696-3119

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Deborah Kroll-Mensing Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598980153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17615 LACEY DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778207",
            "telephone_number": "907-696-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17615 LACEY DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778207",
            "telephone_number": "907-696-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "DEBORAH",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PH.D., ED.S., L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AK",
            "license": "AK 552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "KROLL-MENSING",
            "prefix": "DR.",
            "credential": "PH.D., L.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Klinger
• Erik P Kohler, MD
• Carly Amelia Kopinski, DC
• Elena Kosbruk
• Daniel J Kosterman, OPTOMETRIST
• Nikki Kronberger
• Claire Kudyba
• Courtney Marie Kujansuu, MSN, RN
• Gail Kurth
• Jasmyne Lacy

• Clinical Child & Adolescent Psychologist in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Clinical Child & Adolescent Psychologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.