Healthcare Provider Details

I. General information

NPI: 1225713787
Provider Name (Legal Business Name): ELENA COURTNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date: 08/07/2026
Reactivation Date: 08/21/2026

III. Provider practice location address

2149 COLLINGWOOD BLVD
TOLEDO OH
43620-1652
US

IV. Provider business mailing address

3400 S DUCK CREEK RD
NORTH JACKSON OH
44451-8603
US

V. Phone/Fax

Practice location:
  • Phone: 419-243-9178
  • Fax:
Mailing address:
  • Phone: 330-774-6447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: