Provider Demographics
NPI:1578046579
Name:HOLBROOK, COURTNEY LAUREN (LCSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LAUREN
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 REGENCY DR APT 539
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2145
Mailing Address - Country:US
Mailing Address - Phone:630-277-7598
Mailing Address - Fax:
Practice Address - Street 1:125 FAIRFIELD WAY STE 380
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-3701
Practice Address - Country:US
Practice Address - Phone:224-279-0408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.101708104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker