MEDICARE: COURTNEY NOLAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	BA60790033	WA
2	103K00000X	Behavior Analyst	BHV-010367	TX

General Provider Information

NPI Number	:	1164949723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY NOLAN

Provider Business Mailing Address
First Line	:	16120 NE 8TH ST
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-3937
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 S MASON RD STE 315
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-3858
Country	:	US
Telephone Number	:	281-652-5200
Fax Number	:	818-357-2505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	05/29/2026

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Directions to “ COURTNEY NOLAN ” Practice Location

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