Provider Demographics
NPI:1417154584
Name:COURTLAND, LLC
Entity Type:Organization
Organization Name:COURTLAND, LLC
Other - Org Name:THE GROWTH CENTER FOR COUNSELING AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAND
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN
Authorized Official - Phone:812-941-9200
Mailing Address - Street 1:4925 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9426
Mailing Address - Country:US
Mailing Address - Phone:812-941-9200
Mailing Address - Fax:812-941-9205
Practice Address - Street 1:4925 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9426
Practice Address - Country:US
Practice Address - Phone:812-941-9200
Practice Address - Fax:812-941-9205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-01
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000734A101YM0800X
IN34005525A1041C0700X
KY0138106H00000X
IN35001337A106H00000X
IN28156610A163WP0807X
IN01043542A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000525541OtherANTHEM