Courtney K Domenico, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007703 Issued in IL

Practice address

1300 W Belmont Ave
Suite 302
Chicago, IL 60657-3200

Phone

(773) 883-5398

NPI assigned

Jul 14, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Courtney D Burtscher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Cdpsyd L.L.C.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1225901234
  NPD Authorized official

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1104055953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "SUITE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "773-883-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "SUITE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "773-883-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMENICO",
        "first_name": "COURTNEY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "BURTSCHER",
            "middle_name": "D",
            "prefix": "DR.",
            "credential": "PSY,D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Michael Dombrowski, M.D.
• Lindsay Dombrowski, PSYD
• Kristen Dome, LPC
• Natalie Nicole Domek, DPM
• Issac Pedro Domenech-Gonzalez
• Shiori Domenighetti
• Brian Domin, DPT
• Madison Domin, PA
• Dominador L. Dayon Jr., M.D.S.C.
• Allison Domingo, LCSW

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.