Provider Demographics
NPI:1598353120
Name:WORSHAM, COURTNEY HAMILTON (MA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:HAMILTON
Last Name:WORSHAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41037 ROCKWELL PL
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1129
Mailing Address - Country:US
Mailing Address - Phone:985-422-1126
Mailing Address - Fax:
Practice Address - Street 1:1180 HIGHWAY 51 STE A
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-6365
Practice Address - Country:US
Practice Address - Phone:985-467-0730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor