Provider Demographics
NPI:1396430765
Name:HOWELL, COURTNEY LEIGH (LSW, LMSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LEIGH
Last Name:HOWELL
Suffix:
Gender:F
Credentials:LSW, LMSW
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:LEIGH
Other - Last Name:RUDOLPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, LMSW
Mailing Address - Street 1:402 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1417
Mailing Address - Country:US
Mailing Address - Phone:419-343-8962
Mailing Address - Fax:
Practice Address - Street 1:3454 OAK ALLEY CT STE 214
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1370
Practice Address - Country:US
Practice Address - Phone:419-210-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.23046511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical