Courtney Clark, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4410 Issued in CT

Practice address

1559 Post Rd Ste 11
Fairfield, CT 06824-5933

Phone

(203) 293-8634

NPI assigned

Feb 15, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• N/a N/a Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Genuine Mind Psychology, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfield, CT
  • NPI 1346059102
  NPD Authorized official
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1003332446
  NPD
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Middletown, CT
  • NPI 1952591851
  NPD

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1821795295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1559 POST RD STE 11",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245933",
            "telephone_number": "203-293-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 POST RD STE 11",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245933",
            "telephone_number": "203-293-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "4410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert Bruce Citrin, PH.D.
• City Medical of Upper East Side, PLLC
• Brian Clancy
• Clarivision-Advanced Eye Care
• Bridget Blake Clark, LPC
• Todd L Clark, APRN
• Clean Rxeach LLC
• Clear Life Counseling and Wellness,PLLC
• Stephanie H Clines, PHD, LAT, ATC
• Candace Clinger, LCSW

• Psychologist in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.

Verify at the official NPI Registry.