Courtney N Lavadia, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61100506 Issued in WA

Practice address

21911 76TH Ave W Ste 110
Edmonds, WA 98026-7918

Phone

(425) 640-4950

Fax

(425) 640-4958

NPI assigned

Aug 13, 2020

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1891306668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W STE 110",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267918",
            "telephone_number": "425-640-4950",
            "fax_number": "425-640-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVADIA",
        "first_name": "COURTNEY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61100506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891306668",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.swedish.org/locations/swedish-edmonds-birth-family-clinic?y_source=1_OTU3NjUzNi03MTUtbG9",
            "affiliation": "N",
            "address_1": "21911 76th Ave W Ste 110",
            "city": "Edmonds",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980267918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Malorie Ann Larson, DPT
• Ally Jaye Latham
• Annie Lau, OTRL
• Michael PH Lau, M.D.
• Emily Carol Lauckhart
• Leslie Lawrence
• Aimee Le
• Kathleen G Leach, ARNP
• Learning to Play, LLC
• Joshua Timothy Leben, CBT

• Clinical Psychologist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.