Active NPI
Mary Lynne Courtney, PH.D.
- Clinical Child & Adolescent Psychologist
- Raleigh, NC
National Provider Identifier
1386620714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 2710
- Practice address
- 7404 Chapel Hill Rd
Raleigh, NC 27607-5043 - Phone
- (919) 415-0050
- Fax
- (919) 467-0979
- NPI assigned
- Dec 18, 2005
- 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 2710 | NC | Primary |
Addresses
Primary practice location
7404 Chapel Hill Rd
Raleigh, NC 27607-5043
Mailing address
PO Box 162
Cary, NC 27512-0162
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6000259 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2710 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386620714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 162",
"city": "CARY",
"state": "NC",
"postal_code": "275120162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7404 CHAPEL HILL RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276075043",
"telephone_number": "919-415-0050",
"fax_number": "919-467-0979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COURTNEY",
"first_name": "MARY LYNNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NC",
"license": "2710",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000259",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- 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.