Individual provider Active NPI

Karen E Courchaine, PH.D.

  • Psychologist
  • Lake City, FL
National Provider Identifier
1982630265
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY5513 Issued in FL
Practice address
619 S Marion Ave
North Florida/South Georgia Veterans Health System
Lake City, FL 32025-5808
Phone
(386) 755-3016
Fax
(386) 754-7370
NPI assigned
Jun 25, 2006
Last updated
Sep 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5513 FL Primary

Addresses

Primary practice location

619 S Marion Ave
North Florida/South Georgia Veterans Health System
Lake City, FL 32025-5808

Mailing address

619 S Marion Ave
North Florida/South Georgia Veterans Health System
Lake City, FL 32025-5808
Phone (386) 755-3016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120710000219 FL Practitioner - Clinical Psychologist 1355234626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Psych Services LLCGroup PAC ID 8820406093, 10 clinicians

Practice addresses (Care Compare)

11750 SW 40 St
Miami, FL 33175-3530
Phone (706) 823-5250

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY5513FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Psych Services LLC Psychologist CurrentSince Nov 10, 2024 Accepting new patients
John P McDonough III Psychologist PastSince Oct 1, 2004 Accepting new patients
Lake Center of H.O.P.E., PA PastSince Mar 17, 1998 Accepting new patients
Lifestream Behavioral Center Inc Past Accepting new patients
GPS II Past Accepting new patients

Locations

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

1265 Interstate Pkwy
#B
Augusta, GA 30909
Phone (706) 204-1366

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1982630265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "address_2": "NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-755-3016",
            "fax_number": "386-754-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "address_2": "NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-755-3016",
            "fax_number": "386-754-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURCHAINE",
        "first_name": "KAREN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.