Provider Demographics
NPI:1700368305
Name:THURSTON, COURTNEY MEGAN (LPC)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:MEGAN
Last Name:THURSTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:259 GRISWOLD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-4162
Mailing Address - Country:US
Mailing Address - Phone:269-419-0242
Mailing Address - Fax:
Practice Address - Street 1:6276 JACKSON RD STE D
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9579
Practice Address - Country:US
Practice Address - Phone:734-956-0051
Practice Address - Fax:888-976-6019
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019096101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health