Active NPI
Courtney Elizabeth McConnell, PSYD
- Clinical Psychologist
- Bakersfield, CA
National Provider Identifier
1740691997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY30034
- Practice address
- 5603 Auburn St Unit a
Bakersfield, CA 93306 - Phone
- (661) 525-3221
- Fax
- (888) 974-1145
- NPI assigned
- May 9, 2014
- Sex
- Female
- Sole proprietor
- No
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 | PSY30034 | CA | Primary |
Addresses
Primary practice location
5603 Auburn St Unit a
Bakersfield, CA 93306
Mailing address
9308 Four Pines Dr
Shafter, CA 93263-9430
Phone (661) 805-2099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220531000086 | TX | Practitioner - Clinical Psychologist | 0840624888 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY30034 | CA | MD | Clinical Psychologist |
| 30034 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maniilaq Association | Current | Accepting new patients | |
| Yakutat Tribal Health Board | Current | Accepting new patients | |
| Maniilaq Association | Current | Accepting new patients | |
| Maniilaq Association | Current | Accepting new patients | |
| Caring Insight Psychological Services, Inc. | Clinical | Past | Accepting new patients |
Interoperability endpoints
- courtney.mcconnell.p1@direct.omnifamilyhealth.nextgenshare.com
Organizations & group practices 5
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.
-
- Clinical Psychologist
- Shafter, CA
- NPI 1417545872
Clinical
-
- Critical Access Hospital
- Kotzebue, AK
- NPI 1316995210
-
- Federal Public Health Clinic/Center
- Ambler, AK
- NPI 1427325133
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534032000000",
"number": "1740691997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9308 FOUR PINES DR",
"city": "SHAFTER",
"state": "CA",
"postal_code": "932639430",
"telephone_number": "661-805-2099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5603 AUBURN ST UNIT A",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "93306",
"telephone_number": "661-525-3221",
"fax_number": "888-974-1145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "COURTNEY",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-09",
"last_updated": "2018-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY30034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.