Courtney, John C
Courtney, John C is an sole proprietor health care provider with primary practice located at 1200 Highway 60 , Socorro NM 87801-3914. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Prescribing (Medical), Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Prescribing (Medical) is his primary health care specialty. Courtney, John C can be contacted via phone (575) 835-2444.Contact Information
Primary practice address
1200 Highway 60
Socorro NM 87801-3914
Phone: (575) 835-2444
Fax: (575) 838-0150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Prescribing (Medical) | 103TP0016X | MPAP000019 | Louisiana |
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 1232 | New Mexico |
| Behavioral Health & Social Service Providers / Prescribing (Medical) | 103TP0016X | 0024 | New Mexico |
Profile Details
| NPI number | 1023179538 |
|---|---|
| LBN Legal business name | Courtney, John C |
| Credentials | PSY.D., M.P. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Jun 9th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023179538 | NPPES |
| New Mexico | MEDICAID | 17472717 | |
| New Mexico | MEDICAID | 1004812 |
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