Provider Demographics
NPI:1902133457
Name:ROSEMOND, COURTNEY MARQUIS (MS, CRC, LCAS, LPC)
Entity Type:Individual
Prefix:MR
First Name:COURTNEY
Middle Name:MARQUIS
Last Name:ROSEMOND
Suffix:
Gender:M
Credentials:MS, CRC, LCAS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7281
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-7281
Mailing Address - Country:US
Mailing Address - Phone:252-364-2853
Mailing Address - Fax:252-364-2853
Practice Address - Street 1:1206 EVANS ST
Practice Address - Street 2:SUITE 24
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4102
Practice Address - Country:US
Practice Address - Phone:252-364-2853
Practice Address - Fax:252-364-2853
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1541101YA0400X
NC8362101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional