Provider Demographics
NPI:1851455430
Name:COURTNEY, SANDRA RENEE (BSW, MHPP)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:RENEE
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:BSW, MHPP
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:RENEE
Other - Last Name:COURTNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW, MHPP
Mailing Address - Street 1:4354 STOCKTON DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2917
Mailing Address - Country:US
Mailing Address - Phone:501-955-7600
Mailing Address - Fax:
Practice Address - Street 1:4354 STOCKTON DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2917
Practice Address - Country:US
Practice Address - Phone:501-955-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator