Active NPI
Courtney Parker Whitehead, PSY.D.
- Clinical Psychologist
- Fayetteville, NC
National Provider Identifier
1134478514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4365
- Practice address
- 806 Hay St
Fayetteville, NC 28305-5312 - Phone
- (910) 860-7008
- Fax
- (910) 221-9006
- NPI assigned
- Aug 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4365 | NC | Primary |
Addresses
Primary practice location
806 Hay St
Fayetteville, NC 28305-5312
Mailing address
806 Hay St
Fayetteville, NC 28305-5312
Phone (910) 860-7008
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4365 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353888000000",
"number": "1134478514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "806 HAY ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055312",
"telephone_number": "910-860-7008",
"fax_number": "910-221-9006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 HAY ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055312",
"telephone_number": "910-860-7008",
"fax_number": "910-221-9006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHEAD",
"first_name": "COURTNEY",
"middle_name": "PARKER",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-31",
"last_updated": "2012-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "4365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.