Provider Demographics
NPI:1740529783
Name:SEYMOUR, KOURTNEE (LPCC)
Entity type:Individual
Prefix:
First Name:KOURTNEE
Middle Name:
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:KOURTNEE
Other - Middle Name:
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 W MUHAMMAD ALI BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1423
Mailing Address - Country:US
Mailing Address - Phone:502-589-8600
Mailing Address - Fax:502-589-8745
Practice Address - Street 1:9702 STONESTREET RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-6808
Practice Address - Country:US
Practice Address - Phone:502-589-8600
Practice Address - Fax:502-589-8745
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY170748101YP2500X
KY2013-010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional