Provider Demographics
NPI:1396590725
Name:WARNCKE, COURTNEY RENEE
Entity type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:RENEE
Last Name:WARNCKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4855 RIVERSTONE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4378
Mailing Address - Country:US
Mailing Address - Phone:832-945-3139
Mailing Address - Fax:
Practice Address - Street 1:4855 RIVERSTONE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4378
Practice Address - Country:US
Practice Address - Phone:832-945-3139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1044341041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical