Provider Demographics
NPI:1831567593
Name:CHETTLE, COURTNEY
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:CHETTLE
Suffix:
Gender:
Credentials:
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:J
Other - Last Name:CHETTLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DBH, MA, LPC
Mailing Address - Street 1:14630 N 32ND LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4704
Mailing Address - Country:US
Mailing Address - Phone:480-543-0420
Mailing Address - Fax:
Practice Address - Street 1:7325 N 16TH ST STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5202
Practice Address - Country:US
Practice Address - Phone:480-543-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20286101Y00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor