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General NPI Number Information
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NPI Number | 1912651894
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Entity Type | Individual
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Provider Name | COURTNEY DENEVI BCBA, LBA, LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/09/2022
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1555 S GILBERT RD
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City | MESA
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State | AZ
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Zip | 85204-6000
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Country | US
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Telephone | 480-750-7058
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Fax |
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Provider Business Mailing Address
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Address Line | 1555 S GILBERT RD
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City | MESA
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State | AZ
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Zip | 85204-6000
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Country | US
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Telephone | 480-750-7058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-22770
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW-18370
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-54491
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License Number State | AZ
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