MEDICARE: COURTNEY CHETTLE

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	101Y00000X	Counselor	LPC-20286	AZ

General Provider Information

NPI Number	:	1831567593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY CHETTLE

Provider Business Mailing Address
First Line	:	14630 N 32ND LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-4704
Country	:	US
Telephone Number	:	480-543-0420
Fax Number	:

Provider Business Practice Location Address
First Line	:	7325 N 16TH ST STE 110
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-5202
Country	:	US
Telephone Number	:	480-543-0420
Fax Number	:

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

Provider Enumeration Date	:	09/10/2015
Last Update Date	:	05/02/2025

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Directions to “ COURTNEY CHETTLE ” Practice Location

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