Healthcare Provider Details

I. General information

NPI: 1932046885
Provider Name (Legal Business Name): COURTNEY JO LYNN THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

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

1011 N HIGHWAY 27 STE 8
WHITLEY CITY KY
42653-5025
US

IV. Provider business mailing address

559 BROWNIE DUNCAN RD
WHITLEY CITY KY
42653-4229
US

V. Phone/Fax

Practice location:
  • Phone: 606-310-3860
  • Fax:
Mailing address:
  • Phone: 606-310-3860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number463928
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: