Courtney A Carlson

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0112911 Issued in NY

Practice address

64 Locust Dr
Mastic Beach, NY 11951-5512

Phone

(631) 772-2721

NPI assigned

Jan 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Family Residences and Essential Enterprises, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Old Bethpage, NY
  • NPI 1497943757
  NPD (past)

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306997895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 LOCUST DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119515512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 LOCUST DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119515512",
            "telephone_number": "631-772-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "COURTNEY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "0112911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyra M Burton
• Stacey Lynne Busching, LPN
• Laronda Renee Butts, LPN
• Mariann Cali
• Ashley Campo
• Amour Najee Carrethers
• Mary Chepak, LMSW
• Coby Scaccia PT, PC
• Jhneale Cockburn-Georges
• Nicoletta Colabella

• Occupational Therapist in Mastic Beach, NY
• Providers in Mastic Beach, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.