Courtney Cantrell

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9428 Issued in FL

Practice address

1650 NE 26TH St Ste 201
Wilton Manors, FL 33305-1431

Phone

(954) 947-8580

Fax

(954) 947-8582

NPI assigned

Oct 26, 2015

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2023 through Oct 1, 2027

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.

• Boca Behavioral Health Solutions, LLC

  • Psychologist
  • Boca Raton, FL
  • NPI 1710683891
  NPD Authorized official
• Courtney J. Cantrell, Psy.D., PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilton Manors, FL
  • NPI 1508382755
  Authorized official Same address or phone

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1740652072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 NE 26TH ST STE 201",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051431",
            "telephone_number": "954-947-8580",
            "fax_number": "954-947-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 NE 26TH ST STE 201",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051431",
            "telephone_number": "954-947-8580",
            "fax_number": "954-947-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camp 4 Health
• Katharine Marie Campbell, PH.D., L.C.S.W.
• Robert Cooper Campbell
• Anthony Campo, M.D.
• Candace Lake Ms LMHC PA
• Care Resource Community Health Centers, Inc
• Care Resource Community Health Centers, Inc (Care Resource Pharmacy Oakland Park)
• Care Resource Community Health Centers, Inc (Care Resource Community Health Centers, Inc-Mobile Unit 1)
• Karen Patricia Carroll, OPTICIAN
• Andre Caruso, PSYD

• Clinical Psychologist in Wilton Manors, FL
• Providers in Wilton Manors, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.