Provider Demographics
NPI:1851088942
Name:ZIND, COURTNEY A (PLPC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:A
Last Name:ZIND
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1759 E. ELM ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-3227
Mailing Address - Country:US
Mailing Address - Phone:417-730-9707
Mailing Address - Fax:417-216-6769
Practice Address - Street 1:1335 E. REPUBLIC RD
Practice Address - Street 2:SUITE H
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804
Practice Address - Country:US
Practice Address - Phone:417-719-1440
Practice Address - Fax:417-216-6769
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023039614101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490135506Medicaid