Provider Demographics
NPI:1518461847
Name:BABER, COURTENAY JAMES
Entity Type:Individual
Prefix:
First Name:COURTENAY
Middle Name:JAMES
Last Name:BABER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 MEADOR RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23040-2043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:239 MEADOR RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:VA
Practice Address - Zip Code:23040-2043
Practice Address - Country:US
Practice Address - Phone:804-241-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003852101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional