Courtnie Dyan Ortiz Mowery, MS, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P2302005 Issued in AR

Practice address

2113 S 54TH St Ste 5
Rogers, AR 72758-8169

Phone

(479) 903-0070

NPI assigned

Feb 7, 2023

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 13, 2024 through Feb 13, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Summit Family Counseling, Inc.

  • Mental Health Counselor
  • Rogers, AR
  • NPI 1386166791
  NPD (past)

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1215633524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 S 54TH ST STE 5",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588169",
            "telephone_number": "479-903-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2113 S 54TH ST STE 5",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588169",
            "telephone_number": "479-903-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ MOWERY",
        "first_name": "COURTNIE",
        "middle_name": "DYAN",
        "name_prefix": "Mrs.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2302005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BOARD OF EXAMINERS IN COUNSELING (LPC)",
            "identifier": "P2302005",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oluleke Anthony Olaiya, PMHNP
• Pamela Oldham, PT
• Olive Branch Recovery-Arkansas LLC
• Optimal Therapy of Nwa
• Orthocare Inc
• Morgen Osborn
• Erica Ruth Ostendorf, BCBA
• Carey Oster
• Osu Center for Health Sciences
• Otto Bock Patient Care, LLC

• Mental Health Counselor in Rogers, AR
• Providers in Rogers, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.