Provider Demographics
NPI:1093687873
Name:BERTELLE, COURTNEY (LAC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BERTELLE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:GREYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:4800 N SCOTTSDALE RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7630
Mailing Address - Country:US
Mailing Address - Phone:848-633-9023
Mailing Address - Fax:
Practice Address - Street 1:595 CHESTNUT RIDGE RD STE 4
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-7667
Practice Address - Country:US
Practice Address - Phone:848-633-9023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00886500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional