Provider Demographics
NPI:1588707640
Name:BEDFORD, COURTNEY (LPC, LMHC)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:
Last Name:BEDFORD
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11710 SW 13TH CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4812
Mailing Address - Country:US
Mailing Address - Phone:678-643-2070
Mailing Address - Fax:
Practice Address - Street 1:11710 SW 13TH CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-4812
Practice Address - Country:US
Practice Address - Phone:678-643-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005665101YP2500X
FLMH18805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional