Provider Demographics
NPI:1275245706
Name:MENSINK, COURTNEY RAE (LADC, LPCC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RAE
Last Name:MENSINK
Suffix:
Gender:F
Credentials:LADC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 COUNTY ROAD 10 STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3064
Mailing Address - Country:US
Mailing Address - Phone:763-515-9246
Mailing Address - Fax:
Practice Address - Street 1:3300 COUNTY ROAD 10 STE 100
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-3064
Practice Address - Country:US
Practice Address - Phone:763-515-9246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305760101YA0400X
MN3973101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health