Provider Demographics
NPI:1750526745
Name:ELSON, COURTNEY JILL (PSYD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JILL
Last Name:ELSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14036 STEPHENS RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-2211
Mailing Address - Country:US
Mailing Address - Phone:248-952-8308
Mailing Address - Fax:
Practice Address - Street 1:14036 STEPHENS RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-2211
Practice Address - Country:US
Practice Address - Phone:248-952-8308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6774103T00000X
IL071.007581103TC0700X
MI6301016230103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical