COURTNEY ROLER MAUZY IV BCBA PHD
NPI 1366228025
Psychologist in Syracuse, NY

Active since September 07, 2023PECOS EnrolledAccepts Medicare Assignment
475 IRVING AVE, SYRACUSE, NY 13210(315) 464-3555 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 19, 2024, Sep 7, 2023 (2 updates tracked since 2023).

About Courtney Roler Mauzy Iv Bcba Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COURTNEY ROLER MAUZY IV BCBA PHD (NPI 1366228025) is an individual psychologist in Syracuse, New York, licensed in New York (332649) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1366228025
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameCOURTNEY ROLER MAUZY IVCredential: BCBA PHD
Location Address475 IRVING AVESyracuse, NY 13210-1756
Mailing Address475 Irving Ave, Suite 300Syracuse, NY 13210 · (315) 464-3555 · Fax (315) 464-3551
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 7, 2023
Last NPPES UpdateSeptember 19, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 7, 2023
NPI 1366228025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NY · 332649
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedBehavior AnalystTaxonomy 103K00000X · License 1-20-44673 (GA)
475 IRVING AVE, Syracuse, NY 13210

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Courtney Roler Mauzy Iv Bcba Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436680618
PECOS Enrollment IDI20240927002597
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant (Medical)
475 IRVING AVE, SUITE 418
SYRACUSE, NY 13210
Pediatrics
475 IRVING AVE, SUITE 210
SYRACUSE, NY 13210
Pediatrics
475 IRVING AVE, SUITE 210
SYRACUSE, NY 13210
Family Medicine
475 IRVING AVE, STE 200
SYRACUSE, NY 13210
Family Medicine
475 IRVING AVE, STE 200
SYRACUSE, NY 13210
Family Medicine
475 IRVING AVE, STE 300
SYRACUSE, NY 13210
Family Medicine
475 IRVING AVE, STE 300
SYRACUSE, NY 13210
Family Medicine
475 IRVING AVE, STE 200
SYRACUSE, NY 13210

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366228025, enumerated as an "individual" on September 07, 2023.

The provider is located at 475 IRVING AVE SYRACUSE, NY 13210 and the phone number is (315) 464-3555.

Psychologist with taxonomy code 103T00000X.