Provider Demographics
NPI:1508099300
Name:CAVETT, COURTNEY A (MA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:A
Last Name:CAVETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:A
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:137 MONTGOMERY AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:BOYERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19512-1300
Mailing Address - Country:US
Mailing Address - Phone:872-222-8388
Mailing Address - Fax:
Practice Address - Street 1:137 MONTGOMERY AVE STE 105
Practice Address - Street 2:
Practice Address - City:BOYERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19512-1300
Practice Address - Country:US
Practice Address - Phone:872-222-8388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
PAAPC000235101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst