Individual provider Active NPI

Courtney Kinneard Brown

  • Marriage & Family Therapist
  • Mesa, AZ
National Provider Identifier
1093286171
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1310 S Dobson Rd
Mesa, AZ 85202-4705
Phone
(480) 968-2995
NPI assigned
Dec 16, 2018
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

1310 S Dobson Rd
Mesa, AZ 85202-4705

Mailing address

3538 E Contessa Cir
Mesa, AZ 85213-7039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250117000001 AZ Practitioner - Marriage and Family Therapist 3476081548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mesa Family Therapy LLCGroup PAC ID 0749718815, 4 clinicians

Practice addresses (Care Compare)

1355 N Greenfield Rd
Mesa, AZ 85205-4073
Phone (480) 256-2907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mesa Family Therapy LLC Marriage & Family Therapist CurrentSince Nov 4, 2024 Accepting new patients

Locations

1355 N Greenfield Rd
Mesa, AZ 85205
Phone (480) 256-2907

Organizations & group practices 1

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": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1093286171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3538 E CONTESSA CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852137039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024705",
            "telephone_number": "480-968-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "COURTNEY",
        "middle_name": "KINNEARD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.