Provider Demographics
NPI:1841909470
Name:CELESTINE, COURTNEY M
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:M
Last Name:CELESTINE
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 1:1901 ERASTE LANDRY RD APT 2016
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-1966
Mailing Address - Country:US
Mailing Address - Phone:337-692-3722
Mailing Address - Fax:
Practice Address - Street 1:222 RUE DE JEAN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3388
Practice Address - Country:US
Practice Address - Phone:337-456-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator