Healthcare Provider Details

I. General information

NPI: 1710717301
Provider Name (Legal Business Name): COURTNEY PARMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 W WASHINGTON ST STE 215
TEMPE AZ
85288-1697
US

IV. Provider business mailing address

4539 N 22ND ST STE R
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 928-236-2008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-23740
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: