Kourtney Marie Deboer, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60497597 Issued in WA

Practice address

4412 Araby Church Rd
Frederick, MD 21704-7708

Phone

(667) 285-8488

NPI assigned

Jul 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kourtney Marie Hicks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 21, 2024 through Feb 21, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1992113781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 ARABY CHURCH RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047708",
            "telephone_number": "667-285-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 ARABY CHURCH RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047708",
            "telephone_number": "667-285-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "KOURTNEY",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-24",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "DC",
            "license": "LMFT200001325",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "LMFT0717002067",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60497597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOURTNEY",
            "last_name": "HICKS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tess De Smedt, LMSW
• Nuria E De Souza
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• Miguel Decastro
• Vivian C. Dechosa, M.D.
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• Helen Decker, RBT
• Kristin Deely, CRNP

• Marriage & Family Therapist in Frederick, MD
• Providers in Frederick, MD by specialty
• Marriage & Family Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.