Provider Demographics
NPI:1427144195
Name:HARKINS, COURTNEY AMANDA-BALL (MFT)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:AMANDA-BALL
Last Name:HARKINS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 STONE PNE
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2131
Mailing Address - Country:US
Mailing Address - Phone:949-916-6288
Mailing Address - Fax:
Practice Address - Street 1:1504 BROOKHOLLOW DR STE 111
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5418
Practice Address - Country:US
Practice Address - Phone:714-957-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43611106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist