Individual provider Active NPI

David Joseph Lacourt, PH.D.

  • Psychologist
  • Albuquerque, NM
National Provider Identifier
1316097736
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301002442 Issued in MN
Practice address
4004 Carlisle Blvd NE
Suite F
Albuquerque, NM 87107-4565
Phone
(505) 830-1629
Fax
(505) 869-1640
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 525 NM
Psychologist 103T00000X 6301002442 MN Primary
School Psychologist 103TS0200X 240926 NM

Addresses

Primary practice location

4004 Carlisle Blvd NE
Suite F
Albuquerque, NM 87107-4565

Mailing address

1175 Green Acres LN
Bosque Farms, NM 87068-9017
Phone (505) 869-1801

Other identifiers 1

IdentifierTypeStateIssuer
N0981MedicaidNM

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301002442MNMDPsychologist
240926NMMDSchool Psychologist
525NMMDRenal Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1316097736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 GREEN ACRES LN",
            "city": "BOSQUE FARMS",
            "state": "NM",
            "postal_code": "870689017",
            "telephone_number": "505-869-1801",
            "fax_number": "505-869-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 CARLISLE BLVD NE",
            "address_2": "SUITE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074565",
            "telephone_number": "505-830-1629",
            "fax_number": "505-869-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACOURT",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "525",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "6301002442",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NM",
            "license": "240926",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0981",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.