Deborah R. Kourgelis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05300400 Issued in NJ

Practice address

163 Dayton St
Ridgewood, NJ 07450-4407

Phone

(201) 694-1648

NPI assigned

Apr 10, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Crossroads Counseling & Psychotherapy, LLC

  • Clinical Social Worker
  • Mahwah, NJ
  • NPI 1962989442
  NPD Authorized official

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239321600000",
    "number": "1700029477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FRANKLIN TPKE # 198",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074301325",
            "telephone_number": "201-529-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 DAYTON ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504407",
            "telephone_number": "201-694-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURGELIS",
        "first_name": "DEBORAH",
        "middle_name": "R.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2009-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05300400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel E. Kopelman, M.D.
• Iris H Kopeloff, M.D.
• Anna M Korkis, MD
• Andrea Korn, LSW
• Jessica Kornwasser, PSY.D.
• Bernadette A Kowalchuk, MFT
• Alexandra Kratch, PT, DPT
• Asimina I Kremos, LSW
• Bradford Douglas Krill, MSW, LCSW
• Ksenia Krivor, MSW

• Clinical Social Worker in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; 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.