Individual provider Active NPI

Courtney Philcox

  • Counselor
  • Glastonbury, CT
National Provider Identifier
1619419520
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
115 Fern St
Glastonbury, CT 06033-2824
Phone
(860) 593-0456
NPI assigned
Nov 9, 2016
Last updated
Mar 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CT Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

115 Fern St
Glastonbury, CT 06033-2824

Mailing address

115 Fern St
Glastonbury, CT 06033-2824
Phone (860) 593-0456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240919002096 CT Practitioner - Mental Health Counselor 5395286140 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3710CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Jul 15, 2024 Accepting new patients
Cornerstone Counseling Center Current Accepting new patients
Community Health Center Inc CurrentSince Jul 15, 2024 Accepting new patients

Locations

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

966 S Main St
Plantsville, CT 06479
Phone (860) 736-5386

Organizations & group practices 3

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": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1619419520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FERN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332824",
            "telephone_number": "860-593-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FERN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332824",
            "telephone_number": "860-593-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILCOX",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2023-03-03",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.