Provider Demographics
NPI:1215760186
Name:LESTER, COURTNEY SHAY (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:SHAY
Last Name:LESTER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 SYLVAN KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-5360
Mailing Address - Country:US
Mailing Address - Phone:860-550-5477
Mailing Address - Fax:
Practice Address - Street 1:272 SYLVAN KNOLL RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-5360
Practice Address - Country:US
Practice Address - Phone:860-550-5477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-24
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF406119-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health