Provider Demographics
NPI:1811882269
Name:DEYO, COURTNEY MARIE (CSAC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:DEYO
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-2804
Mailing Address - Country:US
Mailing Address - Phone:715-314-1831
Mailing Address - Fax:
Practice Address - Street 1:840 STATE ROAD 136 STE 1
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-9252
Practice Address - Country:US
Practice Address - Phone:608-477-9858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17018-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)