Healthcare Provider Details

I. General information

NPI: 1366389330
Provider Name (Legal Business Name): COURTNEY WOODS THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 MADISON ST
EVANSTON IL
60202-2207
US

IV. Provider business mailing address

714 REBA PL UNIT 3
EVANSTON IL
60202-2617
US

V. Phone/Fax

Practice location:
  • Phone: 847-440-7361
  • Fax:
Mailing address:
  • Phone: 317-459-8540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY WOODS
Title or Position: OWNER
Credential: LCSW
Phone: 317-459-8540