Provider Demographics
NPI:1568771665
Name:FERENZ, COURTNEY ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ANNE
Last Name:FERENZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 N VAN DORN ST
Mailing Address - Street 2:APT 101
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1613
Mailing Address - Country:US
Mailing Address - Phone:202-492-7949
Mailing Address - Fax:
Practice Address - Street 1:8519 TUTTLE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1508
Practice Address - Country:US
Practice Address - Phone:703-451-8041
Practice Address - Fax:703-569-5365
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004192103TC0700X
DCPSY1000643103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical