Provider Demographics
NPI:1932256096
Name:LAND, COURTNEY E (DMIN LMHC LMFT)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:E
Last Name:LAND
Suffix:
Gender:M
Credentials:DMIN LMHC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9426
Mailing Address - Country:US
Mailing Address - Phone:812-941-9200
Mailing Address - Fax:812-941-9205
Practice Address - Street 1:4925 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9426
Practice Address - Country:US
Practice Address - Phone:812-941-9200
Practice Address - Fax:812-941-9205
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000734A101YM0800X
IN35001337A106H00000X
KY0138106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist