Courtney Clippert-Treadwell, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

076712 Issued in IA

Practice address

3510 Lincoln Way Ste 300
Ames, IA 50014-7533

Phone

(515) 292-9251

Fax

(844) 895-6179

NPI assigned

Feb 20, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 31, 2019 through Jul 31, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Ames Psychological Wellness Center, PLC

  • Counseling Psychologist
  • Ames, IA
  • NPI 1861931131
  NPD (past)

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1891234142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 LINCOLN WAY STE 300",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500147533",
            "telephone_number": "515-292-9251",
            "fax_number": "844-895-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 LINCOLN WAY STE 300",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500147533",
            "telephone_number": "515-292-9251",
            "fax_number": "844-895-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIPPERT-TREADWELL",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IA",
            "license": "076712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Margaret Clark
• John Edward Clary, DDS
• Paula J Clatt
• Clear Brook Counseling Professionals, LLC
• Edward J. Clemmons, DO
• Derek Paul Cloyd
• Mark Christopher Coberley, MS ATC LAT CSCS PES
• Melissa M. Collins, AUD.
• Community and Family Resources
• Compass Tree LLC

• Counseling Psychologist in Ames, IA
• Providers in Ames, IA by specialty
• Counseling Psychologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.