Individual provider Active NPI

Courtney Lodin

  • Clinical Psychologist
  • Provo, UT
National Provider Identifier
1528528833
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
13534519-2501 Issued in UT
Practice address
1300 E Center St
Provo, UT 84606-3554
Phone
(801) 344-4215
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 13534519-2501 UT Primary

Addresses

Primary practice location

1300 E Center St
Provo, UT 84606-3554

Mailing address

PO Box 270
Provo, UT 84603-0270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104002300 UT Practitioner - Clinical Psychologist 2062945694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of UtahGroup PAC ID 6800797333, 29 clinicians

Practice addresses (Care Compare)

1300 E Ctr St
Utah State Hospital
Provo, UT 84606-3554
Phone (801) 344-4215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13534519-2501UTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Utah CurrentSince Sep 3, 2024 Accepting new patients

Locations

1300 E Center St
Provo, UT 84606
Phone (801) 344-4215

Organizations & group practices 1

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1528528833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846030270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E CENTER ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846063554",
            "telephone_number": "801-344-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODIN",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "13534519-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.