Provider Demographics
NPI:1396534616
Name:BREINER, COURTNEY ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:BREINER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-5132
Mailing Address - Country:US
Mailing Address - Phone:518-376-2543
Mailing Address - Fax:
Practice Address - Street 1:18 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-5132
Practice Address - Country:US
Practice Address - Phone:518-376-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027175103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical