NPIMap

Organization Active NPI

Courtney Rennicke, PH.D. PLLC

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1558622928
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
68017456 Issued in NY
Legal business name
COURTNEY RENNICKE, PH.D. PLLC
Practice address
530 Broadway FL 4
New York, NY 10012-3920
Phone
(212) 337-3565
NPI assigned
Jun 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Authorized official

Name
Courtney Rennicke, PH.D.NPI 1083897383
Title
Executive Director
Phone
(212) 337-3565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 68017456 NY Primary

Addresses

Primary practice location

530 Broadway FL 4
New York, NY 10012-3920

Mailing address

530 Broadway FL 4
New York, NY 10012-3920
Phone (212) 337-3565

Other names 1

  • Rennicke & Associates Doing business as

National Provider Directory

National Provider Directory

Locations

530 Broadway
Fl 4
New York, NY 10012
Phone (212) 337-3565

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1558622928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 BROADWAY FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123920",
            "telephone_number": "212-337-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 BROADWAY FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123920",
            "telephone_number": "212-337-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTNEY RENNICKE, PH.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-01",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "RENNICKE",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "212-337-3565",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68017456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rennicke & Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.