Individual provider Active NPI

Deborah A O'Donnell, PHD

  • Clinical Child & Adolescent Psychologist
  • Lexington Park, MD
National Provider Identifier
1679701866
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
03958 Issued in MD
Practice address
48853 Havirland Rd
Lexington Park, MD 20653-3035
Phone
(240) 895-4345
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 03958 MD Primary
Family Psychologist 103TF0000X 03958 MD

Addresses

Primary practice location

48853 Havirland Rd
Lexington Park, MD 20653-3035

Mailing address

48853 Havirland Rd
Lexington Park, MD 20653-3035
Phone (240) 895-4345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20210510001450 MD Practitioner - Clinical Psychologist 6507275278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

41660 Courthouse Dr
Leonardtown, MD 20650-3887
Phone (240) 587-0457

P O Box
Suite 1212
Leonardtown, MD 20650-1212

PO Box
Suite 1212
Leonardtown, MD 20650-1212

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03958MDMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah a Odonnell, PHD, Clinical Psychologist, LLC Clinical Child & Adolescent CurrentSince Feb 1, 2021 Accepting new patients

Locations

41660 Courthouse Dr
#201C
Leonardtown, MD 20650
Phone (240) 587-0457

41660 Courthouse Dr
Leonardtown, MD 20650
Phone (240) 309-2351

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1679701866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48853 HAVIRLAND RD",
            "city": "LEXINGTON PARK",
            "state": "MD",
            "postal_code": "206533035",
            "telephone_number": "240-895-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48853 HAVIRLAND RD",
            "city": "LEXINGTON PARK",
            "state": "MD",
            "postal_code": "206533035",
            "telephone_number": "240-895-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "03958",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MD",
            "license": "03958",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington Park, MD

Sources for this page

Verify at the official NPI Registry.