Healthcare Provider Details

I. General information

NPI: 1811405475
Provider Name (Legal Business Name): COURTNEY SISCO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: COURTNEY MARKOWITZ

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 S MAIN ST UNIT 2
THREE FORKS MT
59752-8956
US

IV. Provider business mailing address

2975 MAX AVE # 1042
BOZEMAN MT
59718-7143
US

V. Phone/Fax

Practice location:
  • Phone: 406-630-5542
  • Fax:
Mailing address:
  • Phone: 805-655-3460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number57682
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number119812
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: