Individual provider Active NPI

Courtney Danielle Prudhomme, M.ED, LPC, NCC

  • Professional Counselor
  • Kingwood, TX
National Provider Identifier
1043965692
Registry record updated Feb 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
79912 Issued in TX
Practice address
2611 Bens Branch Dr Apt 2604
Kingwood, TX 77339-4916
Phone
(409) 659-8416
NPI assigned
Feb 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 79912 TX Primary

Addresses

Primary practice location

2611 Bens Branch Dr Apt 2604
Kingwood, TX 77339-4916

Mailing address

2611 Bens Branch Dr Apt 2604
Kingwood, TX 77339-4916
Phone (409) 659-8416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
79912TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644624000000",
    "number": "1043965692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 BENS BRANCH DR APT 2604",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394916",
            "telephone_number": "409-659-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 BENS BRANCH DR APT 2604",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394916",
            "telephone_number": "409-659-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDHOMME",
        "first_name": "COURTNEY",
        "middle_name": "DANIELLE",
        "credential": "M.ED, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-12",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; 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.