Provider Demographics
NPI:1447672720
Name:BRANDON, COURTNEY ASHLEY (LPC/MHSP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ASHLEY
Last Name:BRANDON
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 CEDARDALE LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1547
Mailing Address - Country:US
Mailing Address - Phone:865-621-4044
Mailing Address - Fax:
Practice Address - Street 1:10426 JACKSON OAKS WAY
Practice Address - Street 2:STE 102
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-0711
Practice Address - Country:US
Practice Address - Phone:865-621-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health