Active NPI
Kourtney Bennett
- Psychologist
- Towson, MD
National Provider Identifier
1487502084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 05931
- Practice address
- 100 West Rd Ste 300
Towson, MD 21204-2370 - Phone
- (443) 842-6580
- NPI assigned
- Mar 19, 2026
- Last updated
- Jul 27, 2026
- Sex
- Unspecified or another gender identity
- 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 | 05931 | MD | Primary |
Addresses
Primary practice location
100 West Rd Ste 300
Towson, MD 21204-2370
Mailing address
8303 Six Forks Rd Ste 207
Raleigh, NC 27615-3094
Other practice location 1
8303 Six Forks Rd Ste 207
Raleigh, NC 27615-3094
Phone (919) 245-7791
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05931 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785110400000",
"number": "1487502084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8303 SIX FORKS RD STE 207",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WEST RD STE 300",
"city": "TOWSON",
"state": "MD",
"postal_code": "212042370",
"telephone_number": "443-842-6580"
}
],
"practiceLocations": [
{
"address_1": "8303 Six Forks Rd Ste 207",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276153094",
"country_code": "US",
"telephone_number": "919-245-7791",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENNETT",
"first_name": "KOURTNEY",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2026-03-19",
"last_updated": "2026-07-27",
"certification_date": "2026-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "05931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Towson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.