Active NPI
Courtney Tibbetts, PSY.D
- Clinical Psychologist
- Lafayette, LA
National Provider Identifier
1568989184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1463
- Practice address
- 1538 W Pinhook Rd
Lafayette, LA 70503-3159 - Phone
- (337) 234-4912
- NPI assigned
- Aug 24, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1463 | LA | Primary |
Addresses
Primary practice location
1538 W Pinhook Rd
Lafayette, LA 70503-3159
Mailing address
1538 W Pinhook Rd
Lafayette, LA 70503-3159
Phone (337) 234-4912
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 |
|---|---|---|---|
| 1463 | LA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lafayette Psychology Center, LLC | Clinical | Current | Accepting new patients |
Locations
1538 W Pinhook Rd
Lafayette, LA 70503
Phone (337) 234-4912
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": "1503532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1568989184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1538 W PINHOOK RD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705033159",
"telephone_number": "337-234-4912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1538 W PINHOOK RD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705033159",
"telephone_number": "337-234-4912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBBETTS",
"first_name": "COURTNEY",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-24",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "LA",
"license": "1463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.