Courtnay Wilson, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

048.0132465 Issued in VT

Practice address

357 Shields Dr
Bennington, VT 05201-9810

Phone

(802) 447-1409

NPI assigned

Jan 8, 2018

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

Enrolled in VT, CT2 enrollments

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.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Neuropsychology LLCGroup PAC ID 3375602931, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Northeast Neuropsychology, LLC

  • Clinical Neuropsychologist
  • Cheshire, CT
  • NPI 1396991956
  Medicare reassignment Care Compare group NPD
• Memory Clinic, Inc.

  • Behavioral Neurology & Neuropsychiatry Physician
  • Bennington, VT
  • NPI 1205359213

  Clinical Neuropsychologist

  Medicare reassignment NPD
• Advanced Telepsych PLLC

  • Psychiatry Physician
  • Middletown, CT
  • NPI 1508456377
  NPD (past)

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1982111241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 SHIELDS DR",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052019810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 SHIELDS DR",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052019810",
            "telephone_number": "802-447-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "COURTNAY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VT",
            "license": "048.0132465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey K Whitten, NP
• Monica L Wielt, LICSW
• Justin Carl Wilkinson, ATS
• Suzanne Willard
• William J Sarchino, DPM
• Grace Becker Wilson, LIC SW
• Gregory Wilson, PHARMD
• Sarah Handley Winchester, LICSW
• Angela Wingate, MD
• Richard A Wiseman, MD

• Clinical Neuropsychologist in Bennington, VT
• Providers in Bennington, VT by specialty
• Clinical Neuropsychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.