MEDICARE: COURTNEY M EVERETT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	Q1-0012671	DE

General Provider Information

NPI Number	:	1730975707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY M EVERETT

Provider Business Mailing Address
First Line	:	2500 W 7TH ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-2820
Country	:	US
Telephone Number	:	302-494-2672
Fax Number	:

Provider Business Practice Location Address
First Line	:	2317 QUESENBERRY DR
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-0859
Country	:	US
Telephone Number	:	302-494-2672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2025
Last Update Date	:	06/11/2026

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Directions to “ COURTNEY M EVERETT ” Practice Location

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