Provider Demographics
NPI:1275933368
Name:WOODCOX, COURTNEY (MA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:WOODCOX
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:8488 YORKRIDGE CT
Mailing Address - Street 2:UNIT D
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-2742
Mailing Address - Country:US
Mailing Address - Phone:812-455-5571
Mailing Address - Fax:
Practice Address - Street 1:8488 YORKRIDGE CT
Practice Address - Street 2:UNIT D
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2742
Practice Address - Country:US
Practice Address - Phone:812-455-5571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-14-15670103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst