Provider Demographics
NPI:1396179412
Name:POOL, COURTNEY LAYNE (LCSW/LISW)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:LAYNE
Last Name:POOL
Suffix:
Gender:F
Credentials:LCSW/LISW
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:LAYNE
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2701 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5351
Mailing Address - Country:US
Mailing Address - Phone:309-779-3200
Mailing Address - Fax:309-779-2755
Practice Address - Street 1:2701 17TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5351
Practice Address - Country:US
Practice Address - Phone:309-779-3200
Practice Address - Fax:309-779-2755
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490157411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical