NPIMap

Organization Active NPI

Courtney Du Mond, PH.D. Licensed Clinical Psychologist

Doing business as Lakeside Behavioral Health

  • Clinical Psychologist
  • Auburn, NY
National Provider Identifier
1144606138
Registry record updated Feb 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
019038-1 Issued in NY
Legal business name
COURTNEY DU MOND, PH.D. LICENSED CLINICAL PSYCHOLOGIST
Doing business as
Lakeside Behavioral Health
Practice address
2 South St
Ste 204
Auburn, NY 13021-3833
Phone
(315) 558-7631
Fax
(315) 370-9964
NPI assigned
Aug 3, 2015
Last updated
Feb 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2017

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

Authorized official

Name
Dr. Courtney Elizabeth Du Mond, PHDNPI 1881996403
Title
Psychologist
Phone
(315) 558-7631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 019038-1 NY Primary

Addresses

Primary practice location

2 South St
Ste 204
Auburn, NY 13021-3833

Mailing address

2 South St
Suite 204
Auburn, NY 13021-3833
Phone (315) 558-7631

Other names 1

  • Lakeside Behavioral Health Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487376000000",
    "number": "1144606138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SOUTH ST",
            "address_2": "SUITE 204",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213833",
            "telephone_number": "315-558-7631",
            "fax_number": "315-253-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SOUTH ST",
            "address_2": "STE 204",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213833",
            "telephone_number": "315-558-7631",
            "fax_number": "315-370-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTNEY DU MOND, PH.D. LICENSED CLINICAL PSYCHOLOGIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2017-02-18",
        "status": "A",
        "authorized_official_last_name": "DU MOND",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "315-558-7631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019038-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2017; 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.