Healthcare Provider Details

I. General information

NPI: 1124149265
Provider Name (Legal Business Name): MARIE E COURNOYER M.S. RN CS-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10630 LITTLE PATUXENT PKWY STE 212
COLUMBIA MD
21044-6226
US

IV. Provider business mailing address

6700 DUCKETTS LN
ELKRIDGE MD
21075-6126
US

V. Phone/Fax

Practice location:
  • Phone: 410-740-0333
  • Fax: 410-740-0332
Mailing address:
  • Phone: 410-796-8140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberR072594
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberR072594
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR072594
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR072594
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: