Courtney, Suzanne

Courtney, Suzanne is an sole proprietor health care provider with primary practice located at 129 Franklin Pl , South Bend IN 46601-1543. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Courtney, Suzanne can be contacted via phone (574) 234-5606.

Contact Information

Primary practice address
129 Franklin Pl South Bend IN 46601-1543
Phone: (574) 234-5606
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 20041640A Indiana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20041640A Indiana

Profile Details

NPI number 1629222088
LBN Legal business name Courtney, Suzanne
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 12th, 2008
Last updated Oct 17th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629222088 NPPES
Indiana MEDICAID 300017016

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