Provider Demographics
NPI:1689077513
Name:CENNAMI, COURTNEY (MS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:CENNAMI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PUMPING STATION RD
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5718
Mailing Address - Country:US
Mailing Address - Phone:978-335-8737
Mailing Address - Fax:
Practice Address - Street 1:18 PUMPING STATION RD
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-5718
Practice Address - Country:US
Practice Address - Phone:978-335-8737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health