Individual provider Active NPI

Courtney McCubbin, LCPC

  • Professional Counselor
  • Baltimore, MD
National Provider Identifier
1669006953
Registry record updated Sep 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC12366 Issued in MD
Practice address
924 Tyson St
Baltimore, MD 21201-4811
Phone
(443) 635-0070
Fax
(844) 225-4606
NPI assigned
Feb 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC12366 MD Primary

Addresses

Primary practice location

924 Tyson St
Baltimore, MD 21201-4811

Mailing address

924 Tyson St
Baltimore, MD 21201-4811
Phone (202) 870-4732

Other practice location 1

4639 Falls Rd
Baltimore, MD 21209-4914
Phone (443) 708-7673

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
LC12366MDMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663459200000",
    "number": "1669006953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 TYSON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014811",
            "telephone_number": "202-870-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 TYSON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014811",
            "telephone_number": "443-635-0070",
            "fax_number": "844-225-4606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4639 Falls Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212094914",
            "country_code": "US",
            "telephone_number": "443-708-7673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCUBBIN",
        "first_name": "COURTNEY",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2022-09-18",
        "certification_date": "2022-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2022; 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.