Provider Demographics
NPI:1184345100
Name:TRIMMER, COURTNEY RUTH (LPC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RUTH
Last Name:TRIMMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 DIAMANTE DR
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-2170
Mailing Address - Country:US
Mailing Address - Phone:214-213-7980
Mailing Address - Fax:
Practice Address - Street 1:4700 DIAMANTE DR
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-2170
Practice Address - Country:US
Practice Address - Phone:214-213-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional