Provider Demographics
NPI:1285824250
Name:CHATMAN, COURTENAY (BA)
Entity Type:Individual
Prefix:
First Name:COURTENAY
Middle Name:
Last Name:CHATMAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 AIRPORT DR STE 130A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2473
Mailing Address - Country:US
Mailing Address - Phone:614-407-9040
Mailing Address - Fax:614-351-2010
Practice Address - Street 1:2760 AIRPORT DR STE 130A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2473
Practice Address - Country:US
Practice Address - Phone:614-407-9040
Practice Address - Fax:614-351-2010
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0016240104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicare UPIN