Provider Demographics
NPI:1780368043
Name:COURTNEY BEHAVIORAL KIRKPATRICK
Entity type:Organization
Organization Name:COURTNEY BEHAVIORAL KIRKPATRICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-205-2987
Mailing Address - Street 1:109 BRUSH CREEK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-9502
Mailing Address - Country:US
Mailing Address - Phone:724-205-2987
Mailing Address - Fax:
Practice Address - Street 1:109 BRUSH CREEK RD STE 101
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-9502
Practice Address - Country:US
Practice Address - Phone:724-205-2987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty