Provider Demographics
NPI:1477905016
Name:MARSHALL, COURTNEY CAMILLE (MS, LMFT, LVN)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:CAMILLE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MS, LMFT, LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20700 AVALON BLVD
Mailing Address - Street 2:PO BOX 11023
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7720 PAINTER AVE STE C
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2488
Practice Address - Country:US
Practice Address - Phone:323-999-1395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist