Provider Demographics
NPI:1932756335
Name:PYLE, COURTNEY ANN
Entity Type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:ANN
Last Name:PYLE
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 1:23189 BAYPOINT DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2703
Mailing Address - Country:US
Mailing Address - Phone:313-938-2794
Mailing Address - Fax:
Practice Address - Street 1:640 3 MILE RD NW STE G
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49544-8209
Practice Address - Country:US
Practice Address - Phone:517-234-3826
Practice Address - Fax:248-605-3525
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
MI6851110030104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker