Provider Demographics
NPI:1093557563
Name:ADAMSON, COURTNEY DENIELLE (CADC, RADT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:DENIELLE
Last Name:ADAMSON
Suffix:
Gender:
Credentials:CADC, RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 SANTA CLARA DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3558
Mailing Address - Country:US
Mailing Address - Phone:916-840-1893
Mailing Address - Fax:
Practice Address - Street 1:1620 SANTA CLARA DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3558
Practice Address - Country:US
Practice Address - Phone:916-840-1893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1457440222172V00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker