Healthcare Provider Details

I. General information

NPI: 1063163509
Provider Name (Legal Business Name): COURTNEY ALDEEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5015 ADDISON CIR # 1156
ADDISON TX
75001-3308
US

IV. Provider business mailing address

11882 GREENVILLE AVE STE B101
DALLAS TX
75243-0586
US

V. Phone/Fax

Practice location:
  • Phone: 214-631-9208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96196
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: