Healthcare Provider Details

I. General information

NPI: 1528777133
Provider Name (Legal Business Name): COURTNEY CROSS PSYD, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15044 SANDPIPER LN STE 7 PMB 1028
NAPLES FL
34114
US

IV. Provider business mailing address

15044 SANDPIPER LN. STE 7 PMB 1028
NAPLES FL
34114
US

V. Phone/Fax

Practice location:
  • Phone: 201-321-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6346
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY11640
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: