Debra Marie Quackenbush, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

334840-2501 Issued in UT

Practice address

1399 S 700 E
Salt Lake City, UT 84105-2160

Phone

(801) 832-1050

NPI assigned

Jan 3, 2006

Last updated

Aug 17, 2007By the provider in NPPES

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 identifiers 3

Other names 1

• Debbie Quackenbush Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Center for Human Potential

  • Community/Behavioral Health Agency
  • Salt Lake City, UT
  • NPI 1366679441
  NPD (past)
• Center for Human Potential Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Salt Lake City, UT
  • NPI 1548239940
  NPD (past)

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1720066442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 WELLINGTON ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841064118",
            "telephone_number": "801-322-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052160",
            "telephone_number": "801-832-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACKENBUSH",
        "first_name": "DEBRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "334840-2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "I H C",
            "identifier": "1070011059101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATOR'S MUTUAL",
            "identifier": "942938348QU1",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "740411",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBBIE",
            "last_name": "QUACKENBUSH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Theodore James Pysher, MD
• Naim Qaqish, MD
• Zainab Qazalbash
• Susan Jean Quaal, PH.D., APRN
• Bill Quach, MD
• Quality Billing Services Inc
• Quality Care Services
• Quality Health Inc. (Quality Solace Services Hospice)
• Quality Health Inc. (Quality Solace Services-Lifecare)
• Quality Support Solutions, Inc.

• Clinical Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.