Provider Demographics
NPI:1457604795
Name:PARCHMON, COURTNEY ANNE (LPC, CADCI)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ANNE
Last Name:PARCHMON
Suffix:
Gender:F
Credentials:LPC, CADCI
Other - Prefix:MISS
Other - First Name:COURTNEY
Other - Middle Name:ANNE
Other - Last Name:YUHAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:597 NE LOOKOUT AVE
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1208
Mailing Address - Country:US
Mailing Address - Phone:714-420-0208
Mailing Address - Fax:
Practice Address - Street 1:1251 NE ELM ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1206
Practice Address - Country:US
Practice Address - Phone:541-323-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
ORC3849101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500670813Medicaid
OR500677430Medicaid