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NPI Code Detail

MEDICARE: DR. COURTNEY JORGENSON BERNARDIN PHD

MEDICARE: DR. COURTNEY JORGENSON BERNARDIN PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist2025053851MO

General Provider Information

NPI Number : 1225989825
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COURTNEY JORGENSON BERNARDIN PHD
Provider Business Mailing Address
First Line : 1815 CRYSTAL PT
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-6307
Country : US
Telephone Number : 573-881-7633
Fax Number :
Provider Business Practice Location Address
First Line : 205 PORTLAND ST
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-6521
Country : US
Telephone Number : 573-884-6052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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