Provider Demographics
NPI:1225363898
Name:MAHAIRAS, COURTNEY (LMHC, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:
Last Name:MAHAIRAS
Suffix:
Gender:F
Credentials:LMHC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 N NOVA RD STE 112
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4420
Mailing Address - Country:US
Mailing Address - Phone:386-492-9041
Mailing Address - Fax:386-492-9061
Practice Address - Street 1:533 N NOVA RD STE 112
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4420
Practice Address - Country:US
Practice Address - Phone:386-492-9041
Practice Address - Fax:386-492-9061
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 13066101YM0800X
FL1-07-3871103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst