Healthcare Provider Details

I. General information

NPI: 1235657388
Provider Name (Legal Business Name): COURTNEY ALBIN UPCHURCH MAC, LPC, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: COURTNEY ALBIN MAC, LPC, CAADC

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3777 44TH ST SE
KENTWOOD MI
49512-3945
US

IV. Provider business mailing address

3777 44TH ST SE
KENTWOOD MI
49512-3945
US

V. Phone/Fax

Practice location:
  • Phone: 616-209-9192
  • Fax:
Mailing address:
  • Phone: 616-209-9192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: