Provider Demographics
NPI:1346649233
Name:ADDINGTON, COURTNEY (MA,CCC/SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:ADDINGTON
Suffix:
Gender:F
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 STIMMEL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34286-5214
Mailing Address - Country:US
Mailing Address - Phone:330-546-4787
Mailing Address - Fax:
Practice Address - Street 1:1651 STIMMEL ST
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34286-5214
Practice Address - Country:US
Practice Address - Phone:330-546-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.11164235Z00000X
FLSA13771235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist