Provider Demographics
NPI:1730528993
Name:WHITAKER, COURTNEY COLE (LCPC)
Entity type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:COLE
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 WIGWAM PKWY UNIT 7201
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8361
Mailing Address - Country:US
Mailing Address - Phone:702-379-3890
Mailing Address - Fax:
Practice Address - Street 1:3247 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2412
Practice Address - Country:US
Practice Address - Phone:702-776-3500
Practice Address - Fax:725-201-3314
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NVCI1245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst