COURTNEY ANN FORMICOLA M.A., M.PSY
NPI 1417448481
Counselor - Mental Health in Quincy, MA
About Courtney Ann Formicola M.a., M.psy NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COURTNEY ANN FORMICOLA M.A., M.PSY (NPI 1417448481) is an individual mental health provider in Quincy, Massachusetts and active in the NPI registry since May 2018. She has opted out of Medicare through June 20, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Courtney Ann Formicola M.a., M.psy has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 20, 2024 through June 20, 2028.
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.
QUINCY, MA 02169
QUINCY, MA 02169
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Courtney Formicola's NPI number?
The NPI number for Courtney Formicola is 1417448481. It was assigned to this individual provider in the NPPES registry on May 24, 2018.
Where is Courtney Formicola located?
Courtney Formicola practices at 859 Willard St, Quincy, MA 02169. The listed phone number is (914) 384-0915.
What is Courtney Formicola's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Courtney Formicola enrolled in Medicare?
No. Courtney Formicola has opted out of Medicare through June 20, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Courtney Formicola was last updated on May 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Courtney Ann Formicola, M.A., M.PSY · NPI 1417448481
Mental Health provider in Quincy, Massachusetts. Individual provider, active in the CMS NPPES registry since May 24, 2018.
## Identity
- **NPI:** 1417448481 (Entity type: Individual)
- **Enumerated:** May 24, 2018
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 859 WILLARD ST, Quincy, MA 02169-7482
- **Phone:** (914) 384-0915
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through June 20, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** May 24, 2018
---
Source: [NPI Profile](https://npiprofile.com/npi/1417448481) · Data from the CMS NPPES public registry.