Individual provider Active NPI

Courtney Ann Lobraico, PSYD

  • Clinical Neuropsychologist
  • Peabody, MA
National Provider Identifier
1558526376
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
8883 Issued in MA
Practice address
7 Essex Green Dr
Suite 63
Peabody, MA 01960-2961
Phone
(857) 383-0651
Fax
(978) 336-0437
NPI assigned
Jul 21, 2008
Last updated
May 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 8883 MA Primary

Addresses

Primary practice location

7 Essex Green Dr
Suite 63
Peabody, MA 01960-2961

Mailing address

7 Essex Green Dr
Suite 63
Peabody, MA 01960-2961
Phone (857) 383-0651

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
8883MAMDClinical Neuropsychologist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1558526376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ESSEX GREEN DR",
            "address_2": "SUITE 63",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602961",
            "telephone_number": "857-383-0651",
            "fax_number": "978-336-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ESSEX GREEN DR",
            "address_2": "SUITE 63",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602961",
            "telephone_number": "857-383-0651",
            "fax_number": "978-336-0437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBRAICO",
        "first_name": "COURTNEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "8883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.