Provider Demographics
NPI:1588311906
Name:VAN ACKER, COURTNEY (MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:
Last Name:VAN ACKER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 PEPPER VALLEY DR APT 7
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-1773
Mailing Address - Country:US
Mailing Address - Phone:630-849-6554
Mailing Address - Fax:
Practice Address - Street 1:12 W WILSON ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-2891
Practice Address - Country:US
Practice Address - Phone:630-715-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-05
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health