Healthcare Provider Details

I. General information

NPI: 1023977220
Provider Name (Legal Business Name): COURTNEY LYNN FOREMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 E LOCKWOOD AVE
WEBSTER GROVES MO
63119-3141
US

IV. Provider business mailing address

3530 UTAH ST APT 303
SAINT LOUIS MO
63118-2749
US

V. Phone/Fax

Practice location:
  • Phone: 314-968-9600
  • Fax:
Mailing address:
  • Phone: 870-500-8835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: