Provider Demographics
NPI:1508295619
Name:MCQUISTION, COURTNEY (BSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MCQUISTION
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-1306
Mailing Address - Country:US
Mailing Address - Phone:231-420-0448
Mailing Address - Fax:
Practice Address - Street 1:804 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1224
Practice Address - Country:US
Practice Address - Phone:231-420-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical