Courtney Lyn Dumouchelle, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101007526 Issued in MI

Practice address

627 Elliott Ave
Grand Haven, MI 49417-1040

Phone

(616) 447-7799

Fax

(616) 724-4117

NPI assigned

May 25, 2021

Last updated

Aug 3, 2023By the provider in NPPES

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

Other names 1

• Courtney Lyn Martin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1346815941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 D AVE APT 12",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171290",
            "telephone_number": "574-333-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 ELLIOTT AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171040",
            "telephone_number": "616-447-7799",
            "fax_number": "616-724-4117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1651 E Nickerson Ave",
            "address_purpose": "LOCATION",
            "city": "Benton Harbor",
            "state": "MI",
            "postal_code": "490222469",
            "country_code": "US",
            "telephone_number": "269-876-5697",
            "fax_number": "269-359-3730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 D Ave Apt 12",
            "address_purpose": "LOCATION",
            "city": "Grand Haven",
            "state": "MI",
            "postal_code": "494171290",
            "country_code": "US",
            "telephone_number": "574-333-9402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2251 E Paris Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495462431",
            "country_code": "US",
            "telephone_number": "616-447-7799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUMOUCHELLE",
        "first_name": "COURTNEY",
        "middle_name": "LYN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101007526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "MARTIN",
            "middle_name": "LYN",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nancy McKeon Dubuc, PHYSICAL THERAPIST
• Hunter Bradley Dulaney, D.C.
• Frank Young Duncan III, MD
• Dunegrass Counseling
• Brittany Leigh Dykstra, SLP
• Susan E Eadelman, NP
• Kelly Eaton-Kelley

• Speech-Language Pathologist in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.