Individual provider Active NPI

Cortney Del Duffy, PH.D.

  • Clinical Psychologist
  • Duluth, MN
National Provider Identifier
1740763085
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP6283 Issued in MN
Practice address
306 W Superior St Ste 405
Duluth, MN 55802-5017
Phone
(218) 203-9335
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP6283 MN
Clinical Psychologist 103TC0700X LP6283 MN Primary

Addresses

Primary practice location

306 W Superior St Ste 405
Duluth, MN 55802-5017

Mailing address

2827 Jefferson St
Duluth, MN 55812-2323
Phone (612) 910-1653

Other practice location 1

2827 Jefferson St
Duluth, MN 55812-2323
Phone (218) 203-9335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20181127000549 MN Practitioner - Clinical Psychologist 3577817857 Reassigns benefits to 1 organization
Practice locations: Duluth, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

306 W Superior St
Suite 405
Duluth, MN 55802-5017
Phone (218) 203-9335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP6283MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted Psychology CurrentSince Nov 19, 2020 Accepting new patients

Locations

306 W Superior St
Ste 405
Duluth, MN 55802
Phone (218) 203-9335

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1740763085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 JEFFERSON ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558122323",
            "telephone_number": "612-910-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W SUPERIOR ST STE 405",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558025017",
            "telephone_number": "218-203-9335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2827 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558122323",
            "country_code": "US",
            "telephone_number": "218-203-9335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "CORTNEY",
        "middle_name": "DEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP6283",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.