Provider Demographics
NPI:1558688408
Name:LUSTER, COURTNEY LYNNE (MA, LPC)
Entity type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:LYNNE
Last Name:LUSTER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4390 LINDELL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2735
Mailing Address - Country:US
Mailing Address - Phone:314-956-0547
Mailing Address - Fax:
Practice Address - Street 1:5647 DELMAR BLVD STE 226
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112
Practice Address - Country:US
Practice Address - Phone:314-531-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2025-05-22
Deactivation Date:2022-01-24
Deactivation Code:
Reactivation Date:2025-05-22
Provider Licenses
StateLicense IDTaxonomies
MO2010006424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional