Provider Demographics
NPI:1649579871
Name:COURTNEY, THOMAS (MSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:COURTNEY
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 AUSTINS WAY
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1153
Mailing Address - Country:US
Mailing Address - Phone:207-450-7296
Mailing Address - Fax:
Practice Address - Street 1:744 ROOSEVELT TRL STE 207
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-5281
Practice Address - Country:US
Practice Address - Phone:207-450-7296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC6924101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health