Elisabeth O'Rourke

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

024385 Issued in NY

Practice address

15 Cornell Rd
Latham, NY 12110-1491

Phone

(518) 510-3100

NPI assigned

May 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 8, 2022 through Dec 8, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1619533247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CORNELL RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101491",
            "telephone_number": "518-510-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CORNELL RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101491",
            "telephone_number": "518-510-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Washington Ave Social Sciences 399",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122220001",
            "country_code": "US",
            "telephone_number": "518-442-4820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'ROURKE",
        "first_name": "ELISABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024385",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Anna O'Connor, PHD
• Zyra Cortez O'Connor, M.D.
• Colleen O'Donnell-Nichols, RPH
• Emily Rose O'Donnell, FNP-BC
• Aimee O'Keefe, LCSW
• Jacqueline A O'Shea, P.A.
• Lisa A Oberg, N.P.P.
• Theresa Ochei
• Abigail Catherine Oconnor
• Yumeno Nagata Oliver, LMSW

• Clinical Psychologist in Latham, NY
• Providers in Latham, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.