Provider Demographics
NPI:1528498334
Name:DEBORAH J DOXSEE, PHD LLC
Entity type:Organization
Organization Name:DEBORAH J DOXSEE, PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOXSEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:573-474-1877
Mailing Address - Street 1:28 N 8TH ST
Mailing Address - Street 2:STE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7708
Mailing Address - Country:US
Mailing Address - Phone:573-474-1877
Mailing Address - Fax:573-474-1892
Practice Address - Street 1:28 N 8TH ST
Practice Address - Street 2:STE 300
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7708
Practice Address - Country:US
Practice Address - Phone:573-474-1877
Practice Address - Fax:573-474-1892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000174615103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
144339OtherANTHEM BCBS
P00404849OtherMEDICARE PTAN RAILROAD
6152859OtherUNITED BEHAVIORAL HEALTH
463355OtherHEALTHLINK
463355OtherHEALTHLINK