Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Courtney Formosa, LMHC-D

Individual provider Mental Health Counselor · NPI 1720805005

Courtney Formosa, LMHC-D is a Mental Health Counselor in Penn Yan, New York. Qualified in 2021, 5 years ago. Works from 2 locations. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2024

Practice location Address checks out

3 School Dr
Penn Yan, NY 14527-1081
Phone: (315) 924-6050
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 427 New Karner Rd, Albany, NY 12205-3852 — (518) 948-2340

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence D017066-01 (NY)

Record details

NPI number1720805005
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMHC-D
Sole proprietorNo
NPI enumeratedSeptember 26, 2024
Last updated in NPPESJuly 9, 2026
Certification dateJuly 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Penn Yan