Individual
DR. JOHN C COURTNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D., M.P.
Contact information
Practice address
1200 HIGHWAY 60, SOCORRO, NM 87801-3914
(575) 835-2444
(575) 838-0150
Mailing address
PO BOX 2267, SANTA FE, NM 87504-2267
(505) 982-5565
(505) 992-4990
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1232
NM
103TP0016X
Prescribing (Medical) Psychologist
Primary
0024
NM
103TP0016X
Prescribing (Medical) Psychologist
MPAP000019
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004812
—
LA
05
—
17472717
—
NM
Enumeration date
12/12/2006
Last updated
06/09/2015
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