Provider Demographics
NPI:1073855672
Name:HUDDLESTON, COURTNEY LAYNE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:LAYNE
Last Name:HUDDLESTON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:LAYNE
Other - Last Name:HAUGSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 SILVER LAKE RD NW STE 110
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1789
Mailing Address - Country:US
Mailing Address - Phone:516-289-5666
Mailing Address - Fax:651-628-0411
Practice Address - Street 1:332 W SUPERIOR ST STE 300
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1844
Practice Address - Country:US
Practice Address - Phone:218-722-4397
Practice Address - Fax:218-722-4333
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical