ELISABETH O'ROURKE
NPI 1619533247
Psychologist - Clinical in Latham, NY

Q: What is Elisabeth O'rourke's NPI number?

The NPI number for Elisabeth O'rourke is 1619533247. It was assigned to this individual provider in the NPPES registry on May 20, 2019.

Q: What is Elisabeth O'rourke's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Elisabeth O'rourke enrolled in Medicare?

No. Elisabeth O'rourke has opted out of Medicare through December 8, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since May 20, 2019Opted out of Medicare · through Dec 8, 2026

15 CORNELL RD, LATHAM, NY 12110(518) 510-3100 Get Directions Write a Review

NPPES record last updated: March 2, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 2, 2023, Jan 27, 2023, May 20, 2019 (3 updates tracked since 2019).

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About Elisabeth O'rourke NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELISABETH O'ROURKE (NPI 1619533247) is an individual clinical provider in Latham, New York, licensed in New York (024385) and active in the NPI registry since May 2019. She has opted out of Medicare through December 8, 2026 and maintains a secondary practice location in Albany.

NPPES Registry Identity

NPI1619533247

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameELISABETH O'ROURKE

Location Address15 CORNELL RDLatham, NY 12110-1491

Mailing Address15 Cornell RdLatham, NY 12110-1491 · (518) 510-3100

Phone(518) 510-3100

Sole ProprietorNo

Enumeration DateMay 20, 2019

Last NPPES UpdateMarch 2, 20233 updates tracked since enumeration

NPPES CertifiedMarch 2, 2023

✔ NPI 1619533247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NY · 024385

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

15 CORNELL RD, Latham, NY 12110

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Secondary Practice Location 1

Location 11400 Washington Ave Social Sciences 399Albany, NY 12222-0001 · Phone (518) 442-4820

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Elisabeth O'rourke has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 8, 2022 through December 8, 2026.

Opt-Out Effective DateDecember 8, 2022

Opt-Out In Effect ThroughDecember 8, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. KYLE ERICK KILTS LCSW-R

Social Worker (Clinical)