Provider Demographics
NPI:1447810056
Name:COURTNEY, CECILIA (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:COURTNEY
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 1:2025 CASTAIC LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1557
Mailing Address - Country:US
Mailing Address - Phone:865-246-0455
Mailing Address - Fax:
Practice Address - Street 1:2025 CASTAIC LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1557
Practice Address - Country:US
Practice Address - Phone:865-246-0455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health