Provider Demographics
NPI:1417334053
Name:ESTES, CORTNEY SCOTT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CORTNEY
Middle Name:SCOTT
Last Name:ESTES
Suffix:
Gender:M
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:PO BOX 833
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-0833
Mailing Address - Country:US
Mailing Address - Phone:606-329-0727
Mailing Address - Fax:606-329-1327
Practice Address - Street 1:937 29TH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-3021
Practice Address - Country:US
Practice Address - Phone:606-329-0727
Practice Address - Fax:606-329-1327
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical