Provider Demographics
NPI:1912651894
Name:DENEVI, COURTNEY (BCBA, LMSW, MED)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:DENEVI
Suffix:
Gender:F
Credentials:BCBA, LMSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2632 E THOMAS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-8220
Mailing Address - Country:US
Mailing Address - Phone:602-957-2507
Mailing Address - Fax:602-957-2510
Practice Address - Street 1:340 E PALM LN STE 255
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4604
Practice Address - Country:US
Practice Address - Phone:602-918-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1-21-54491103K00000X
AZLMSW-18370104100000X
AZLCSW-227701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker