Courtney Keene Viscomi, PSYD, BCBA

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071.010347 Issued in IL

Practice address

100 Saunders Rd Ste 150
Lake Forest, IL 60045-2526

Phone

(760) 576-9931

NPI assigned

Oct 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kind Psychological and Behavioral Services, Inc.

  • Behavior Analyst
  • Walnut Creek, CA
  • NPI 1265907141
  NPD (past) Authorized official
• Anthony Tucci PHD LLC

  dba Piece By Piece: Neurobehavioral Services

  • Clinical Psychologist
  • Oak Brook, IL
  • NPI 1285282889

  Clinical Neuropsychologist

  NPD (past)

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1649521592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 MERCHANT DR",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025917",
            "telephone_number": "847-469-7537",
            "fax_number": "847-469-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAUNDERS RD STE 150",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452526",
            "telephone_number": "760-576-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCOMI",
        "first_name": "COURTNEY",
        "middle_name": "KEENE",
        "name_prefix": "Dr.",
        "credential": "PSYD, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30968",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071.010347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Jane Versalle, DO
• Victoria Kut MD LTD
• David Vigder, MD
• Mariana Vigiola Cruz, MD
• Michael P Viglione, MD PHD
• Kathryn Vitale, MSN, APN, AGCNS-BC
• Katherine Lynn Voigt, PA-C
• Halle Cecilia Voos, MA, CCC-SLP
• Marianne P. Vuckovich, R.K.T.
• W Brian Ross DDS PC

• Clinical Neuropsychologist in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.