Provider Demographics
NPI:1659666501
Name:BERKENBILE, COURTNEY MICHELLE (MHR, LPC CANDIDATE)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:MICHELLE
Last Name:BERKENBILE
Suffix:
Gender:F
Credentials:MHR, LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 SOUTH ADAMS
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701
Mailing Address - Country:US
Mailing Address - Phone:405-714-3724
Mailing Address - Fax:
Practice Address - Street 1:1625 WEST OWEN K GARRIOTT ROAD # F
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703
Practice Address - Country:US
Practice Address - Phone:580-242-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst