Provider Demographics
NPI:1427397868
Name:HARGIS FOURKILLER, COURTNEY L (MS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:L
Last Name:HARGIS FOURKILLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 WEST HICKORY
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-1333
Mailing Address - Country:US
Mailing Address - Phone:918-557-6813
Mailing Address - Fax:
Practice Address - Street 1:1418 W HICKORY ST
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-3247
Practice Address - Country:US
Practice Address - Phone:918-797-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health