Provider Demographics
NPI:1205394285
Name:WALRAVEN, COURTNEY E (LCSW)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:E
Last Name:WALRAVEN
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 1:6310 GENOA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2708
Mailing Address - Country:US
Mailing Address - Phone:806-855-3050
Mailing Address - Fax:
Practice Address - Street 1:6310 GENOA AVE STE D
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2708
Practice Address - Country:US
Practice Address - Phone:806-855-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX593741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical