Active NPI
Courtney Nelson, PHD
- Psychologist
- Dallas, TX
National Provider Identifier
1386267201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 38157
- Practice address
- 10420 Estate LN
Dallas, TX 75238-2211 - Phone
- (817) 597-6571
- NPI assigned
- May 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 38157 | Primary |
Addresses
Primary practice location
10420 Estate LN
Dallas, TX 75238-2211
Mailing address
10420 Estate LN
Dallas, TX 75238-2211
Phone (817) 597-6571
Other practice location 1
9543 Losa Dr Ste 111
Dallas, TX 75218-3582
Phone (817) 597-6571
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SSN | Other | DOCTOR ON DEMAND |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Https://eastdallastherapy.clientsecure.me | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1386267201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10420 ESTATE LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752382211",
"telephone_number": "817-597-6571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10420 ESTATE LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752382211",
"telephone_number": "817-597-6571"
}
],
"practiceLocations": [
{
"address_1": "9543 Losa Dr Ste 111",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752183582",
"country_code": "US",
"telephone_number": "817-597-6571",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELSON",
"first_name": "COURTNEY",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-27",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": "38157",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOCTOR ON DEMAND",
"identifier": "SSN",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Https://eastdallastherapy.clientsecure.me",
"affiliation": "N",
"endpointDescription": "Client portal",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "9543 Losa Dr Ste 111",
"city": "Dallas",
"state": "TX",
"country_code": "US",
"postal_code": "752183582",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.