Courtney Lyn Dumouchelle, MS, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Grand Haven, MI

NPI 1346815941 · NPPES record last updated Aug 3, 2023

Key facts

NPI
1346815941
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7101007526 (MI)
Practice address
627 Elliott Ave
Grand Haven, MI 49417-1040
Phone
(616) 447-7799
Fax
(616) 724-4117
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7101007526MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech and Voice Solutions LLC Speech-Language Pathologist Current
since Aug 6, 2023
Accepting new patients
Theraplay, Inc. Current
since Aug 6, 2023
Accepting new patients

Locations

627 Elliott Ave
Grand Haven, MI 49417
Phone (231) 327-4252

2251 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 447-7799

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101007526 MI Yes

Addresses

Primary practice location

627 Elliott Ave
Grand Haven, MI 49417-1040

Mailing address

540 D Ave Apt 12
Grand Haven, MI 49417-1290
Phone (574) 333-9402

Other practice location 1

1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Phone (269) 876-5697

Other practice location 2

2251 E Paris Ave SE
Grand Rapids, MI 49546-2431
Phone (616) 447-7799

Other practice location 3

540 D Ave Apt 12
Grand Haven, MI 49417-1290
Phone (574) 333-9402

Other names

  • Courtney Lyn Martin Former name

Other providers in Grand Haven, MI

All providers in Grand Haven, MI · Speech-Language Pathologist in Michigan

Sources for this page

Verify at the official NPI Registry.