Provider Demographics
NPI:1770294571
Name:ROBINSON, COURTNEY GOODWIN
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:GOODWIN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 GENTILLY BLVD STE C-400
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-1700
Mailing Address - Country:US
Mailing Address - Phone:504-944-0453
Mailing Address - Fax:504-944-0095
Practice Address - Street 1:1995 GENTILLY BLVD STE C-400
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-1700
Practice Address - Country:US
Practice Address - Phone:504-944-0453
Practice Address - Fax:504-944-0095
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8088101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health