Provider Demographics
NPI:1205048568
Name:HEBDON, COURTNEY C (LCSW)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:C
Last Name:HEBDON
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 1:904 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2390
Mailing Address - Country:US
Mailing Address - Phone:704-680-6414
Mailing Address - Fax:704-954-8681
Practice Address - Street 1:904 E 8TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2390
Practice Address - Country:US
Practice Address - Phone:704-680-6414
Practice Address - Fax:704-954-8681
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0060371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC006037OtherLCSW LICENSE NUMBER