Individual provider Active NPI

Courtney Daruszka, LMHC

  • Mental Health Counselor
  • Woburn, MA
National Provider Identifier
1508319799
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8035 Issued in MA
Practice address
21 Cummings Park Ste 200
Woburn, MA 01801-2198
Phone
(781) 305-4086
Fax
(781) 305-4087
NPI assigned
Jul 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8035 MA Primary

Addresses

Primary practice location

21 Cummings Park Ste 200
Woburn, MA 01801-2198

Mailing address

21 Cummings Park Ste 200
Woburn, MA 01801-2198
Phone (781) 305-4086

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

LicenseStateTypeSpecialty
8035MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jeanom LLC Mental Health CurrentSince Oct 15, 2023 Accepting new patients
Modern Assistance Programs, Inc. PastSince Mar 8, 2021 Accepting new patients

Locations

21 Cummings Park
Ste 200
Woburn, MA 01801
Phone (781) 305-4086

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.

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1508319799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CUMMINGS PARK STE 200",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012198",
            "telephone_number": "781-305-4086",
            "fax_number": "781-305-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CUMMINGS PARK STE 200",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012198",
            "telephone_number": "781-305-4086",
            "fax_number": "781-305-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARUSZKA",
        "first_name": "COURTNEY",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "8035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.