Provider Demographics
NPI:1235898859
Name:STENZEL, COURTNEY CHRISTINE
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:CHRISTINE
Last Name:STENZEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3681
Mailing Address - Country:US
Mailing Address - Phone:218-322-4101
Mailing Address - Fax:218-999-7068
Practice Address - Street 1:1880 RIVER RD
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-4085
Practice Address - Country:US
Practice Address - Phone:218-327-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3112101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor