Provider Demographics
NPI:1831960830
Name:WINGFIELD, COURTNEY AMBER
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:AMBER
Last Name:WINGFIELD
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 1:2111 JASMINE PKWY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5932
Mailing Address - Country:US
Mailing Address - Phone:229-869-4310
Mailing Address - Fax:
Practice Address - Street 1:3800 MANSELL RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8205
Practice Address - Country:US
Practice Address - Phone:678-893-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor