Provider Demographics
NPI:1265462204
Name:ENGELBRECHT, DEBORAH (MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:ENGELBRECHT
Suffix:
Gender:F
Credentials:MS, PHD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 NW NORTH RIDGE DR # D
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-6389
Mailing Address - Country:US
Mailing Address - Phone:816-228-9811
Mailing Address - Fax:816-228-0748
Practice Address - Street 1:1201 NW NORTH RIDGE DR # D
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-6389
Practice Address - Country:US
Practice Address - Phone:816-228-9811
Practice Address - Fax:816-228-0748
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY01263103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO493376305Medicaid
MO493376305Medicaid