Provider Demographics
NPI:1720429715
Name:HUFFMAN, COURTNEY (LCSW, LCAS)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 DALE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-2569
Mailing Address - Country:US
Mailing Address - Phone:828-244-3779
Mailing Address - Fax:704-496-2231
Practice Address - Street 1:202 S OLD STATESVILLE RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-9700
Practice Address - Country:US
Practice Address - Phone:704-584-9329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0081211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical