Provider Demographics
NPI:1457008229
Name:REINITZ, COURTNEY E (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:E
Last Name:REINITZ
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 FREEPORT AVE NW STE D
Mailing Address - Street 2:
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-1874
Mailing Address - Country:US
Mailing Address - Phone:763-441-1578
Mailing Address - Fax:763-441-1740
Practice Address - Street 1:508 FREEPORT AVE NW STE D
Practice Address - Street 2:
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-1874
Practice Address - Country:US
Practice Address - Phone:763-441-1578
Practice Address - Fax:763-441-1740
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN275581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical