Individual provider Active NPI

John H. Courtney, LCSW

  • Clinical Social Worker
  • Catskill, NY
National Provider Identifier
1073624847
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR020310-1 Issued in NY
Practice address
327 Main St
Catskill, NY 12414-1823
Phone
(518) 943-1517
Fax
(518) 731-9146
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR020310-1 NY Primary

Addresses

Primary practice location

327 Main St
Catskill, NY 12414-1823

Mailing address

PO Box 586
(327 Main Street Suite C)
Catskill, NY 12414-0586
Phone (518) 943-1517

Other identifiers 1

IdentifierTypeStateIssuer
02026864MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110615000707 NY Practitioner - Clinical Social Worker 7719164961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roman Catholic Diocese of Albany NyGroup PAC ID 3274433065, 9 clinicians

Practice addresses (Care Compare)

790 Lancaster St
Albany, NY 12203-1541
Phone (518) 489-4431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR020310-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia County PastSince Aug 9, 2004 Accepting new patients
Columbia County Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073624847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 586",
            "address_2": "(327 MAIN STREET SUITE C)",
            "city": "CATSKILL",
            "state": "NY",
            "postal_code": "124140586",
            "telephone_number": "518-943-1517",
            "fax_number": "518-731-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 MAIN ST",
            "city": "CATSKILL",
            "state": "NY",
            "postal_code": "124141823",
            "telephone_number": "518-943-1517",
            "fax_number": "518-731-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTNEY",
        "first_name": "JOHN",
        "middle_name": "H.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR020310-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02026864",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Catskill, NY

Sources for this page

Verify at the official NPI Registry.