Provider Demographics
NPI:1144776220
Name:GOODROW, COURTNEY SKYE (LMHC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:SKYE
Last Name:GOODROW
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15010 REDCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-1957
Mailing Address - Country:US
Mailing Address - Phone:727-409-2193
Mailing Address - Fax:
Practice Address - Street 1:15010 REDCLIFF DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-1957
Practice Address - Country:US
Practice Address - Phone:727-409-2193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14155101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health