Active NPI
Courtney Joel Park, M.S., CCC-SLP
- Speech-Language Pathologist
- Concord, NH
National Provider Identifier
1871235531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2219
- Practice address
- 124 Hall St Ste H
Concord, NH 03301-3442 - Phone
- (603) 228-9160
- NPI assigned
- Apr 12, 2022
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2219 | NH | Primary |
Addresses
Primary practice location
124 Hall St Ste H
Concord, NH 03301-3442
Mailing address
124 Hall St Ste H
Concord, NH 03301-3442
Phone (603) 228-9160
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3137186 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2219 | NH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Kids Therapies | Speech-Language Pathologist | Past | Accepting new patients |
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.
-
- Pediatric Occupational Therapist
- Concord, NH
- NPI 1689860918
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1871235531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 HALL ST STE H",
"city": "CONCORD",
"state": "NH",
"postal_code": "033013442",
"telephone_number": "603-228-9160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 HALL ST STE H",
"city": "CONCORD",
"state": "NH",
"postal_code": "033013442",
"telephone_number": "603-228-9160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "COURTNEY",
"middle_name": "JOEL",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-12",
"last_updated": "2023-02-27",
"certification_date": "2023-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NH",
"license": "2219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3137186",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.