Provider Demographics
NPI:1386241321
Name:DOWNING, COURTNEY (MA, BCBA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:DOWNING
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SALT CREEK RUN
Mailing Address - Street 2:
Mailing Address - City:PENINSULA
Mailing Address - State:OH
Mailing Address - Zip Code:44264-9465
Mailing Address - Country:US
Mailing Address - Phone:330-718-5995
Mailing Address - Fax:
Practice Address - Street 1:210 SALT CREEK RUN
Practice Address - Street 2:
Practice Address - City:PENINSULA
Practice Address - State:OH
Practice Address - Zip Code:44264-9465
Practice Address - Country:US
Practice Address - Phone:330-718-5995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-18-32097103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst