Provider Demographics
NPI:1508411711
Name:GUNDRUM, COURTNEY (PSYD, LPCC)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:GUNDRUM
Suffix:
Gender:F
Credentials:PSYD, LPCC
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:KREILKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8617 W POINT DOUGLAS RD S STE 150
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-4161
Mailing Address - Country:US
Mailing Address - Phone:612-293-5037
Mailing Address - Fax:
Practice Address - Street 1:8617 W POINT DOUGLAS RD S STE 150
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-4161
Practice Address - Country:US
Practice Address - Phone:612-293-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health