Provider Demographics
NPI:1871941542
Name:JAMES, COURTNEY ALLEN (MSW,LCSWA)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:ALLEN
Last Name:JAMES
Suffix:
Gender:F
Credentials:MSW,LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 WATERSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-7271
Mailing Address - Country:US
Mailing Address - Phone:910-408-8473
Mailing Address - Fax:
Practice Address - Street 1:2505 S 17TH ST STE 200
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7992
Practice Address - Country:US
Practice Address - Phone:910-254-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0106051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical