Provider Demographics
NPI:1952188542
Name:COURTNEY WALRAVEN LCSW PLLC
Entity Type:Organization
Organization Name:COURTNEY WALRAVEN LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WALRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-S
Authorized Official - Phone:806-319-1864
Mailing Address - Street 1:5504 WAYNE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-4137
Mailing Address - Country:US
Mailing Address - Phone:806-855-3050
Mailing Address - Fax:806-256-6977
Practice Address - Street 1:5504 WAYNE AVE STE 106
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-4137
Practice Address - Country:US
Practice Address - Phone:806-855-3050
Practice Address - Fax:806-256-6977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty