Provider Demographics
NPI:1497527220
Name:LAYTON, COURTNEY NICHOLE (PLADC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:NICHOLE
Last Name:LAYTON
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 S KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-7024
Mailing Address - Country:US
Mailing Address - Phone:402-303-8433
Mailing Address - Fax:402-462-4699
Practice Address - Street 1:907 S KANSAS AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-7024
Practice Address - Country:US
Practice Address - Phone:402-303-8433
Practice Address - Fax:402-462-4699
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-2104101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty