Provider Demographics
NPI:1376276576
Name:CAROLAND, COURTNEY GWIN
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:GWIN
Last Name:CAROLAND
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 1:3069 BROAD ST STE 9
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-3083
Mailing Address - Country:US
Mailing Address - Phone:423-517-7070
Mailing Address - Fax:423-208-9022
Practice Address - Street 1:3069 BROAD ST STE 9
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-3083
Practice Address - Country:US
Practice Address - Phone:423-517-7070
Practice Address - Fax:423-208-9022
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional