Provider Demographics
NPI:1407512106
Name:HOLBROOK, COURTNEY EVE (LCSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:EVE
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18800 EGRET BAY BLVD APT 602
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3290
Mailing Address - Country:US
Mailing Address - Phone:346-435-5160
Mailing Address - Fax:
Practice Address - Street 1:18800 EGRET BAY BLVD APT 602
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3290
Practice Address - Country:US
Practice Address - Phone:346-435-5160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1037891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical