Provider Demographics
NPI:1073858478
Name:MYERS, COURTNEY (LMFT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 LINDSAYS RUN
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9540
Mailing Address - Country:US
Mailing Address - Phone:919-414-7607
Mailing Address - Fax:
Practice Address - Street 1:1756 HERITAGE CENTER DR STE 104
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-8796
Practice Address - Country:US
Practice Address - Phone:984-235-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8035A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist