Individual provider Active NPI

Courtney Lucero, MS, CCC-SLP

  • Speech-Language Pathologist
  • Scottsdale, AZ
National Provider Identifier
1780916676
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6596 Issued in AZ
Practice address
32 Spur Cir
Scottsdale, AZ 85251
Phone
(480) 945-0185
NPI assigned
Feb 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6596 AZ Primary

Addresses

Primary practice location

32 Spur Cir
Scottsdale, AZ 85251

Mailing address

210 W Flamingo Dr
Chandler, AZ 85286-7785
Phone (480) 235-3880

Other identifiers 1

IdentifierTypeStateIssuer
1780916676MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200501000368 AZ Practitioner - Qualified Speech Language Pathologist 8921438193 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6596AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay4Kidz, LLC Speech-Language Pathologist CurrentSince Jan 1, 2020 Accepting new patients
Achievement Therapy Services Past Accepting new patients
Therapy Matters, Inc. Speech-Language Pathologist PastSince Oct 6, 2024 Accepting new patients

Locations

21045 N 9th Pl
Ste 204
Phoenix, AZ 85024
Phone (480) 548-2601

21630 N 19th Ave
Ste B3
Phoenix, AZ 85027
Phone (480) 235-7588

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

Organizations & group practices 3

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": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1780916676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W FLAMINGO DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852867785",
            "telephone_number": "480-235-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 SPUR CIR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85251",
            "telephone_number": "480-945-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-03",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "6596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780916676",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.