MEDICARE: COURTNEY WALRAVEN LCSW PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1952188542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COURTNEY WALRAVEN LCSW PLLC

Provider Business Mailing Address
First Line	:	6310 GENOA AVE STE D
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-2708
Country	:	US
Telephone Number	:	806-855-3050
Fax Number	:	806-256-6977

Provider Business Practice Location Address
First Line	:	6310 GENOA AVE STE D
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-2708
Country	:	US
Telephone Number	:	806-855-3050
Fax Number	:	806-256-6977

Authorized Official
Title or Position	:	OWNER & OPERATOR
Name	:	COURTNEY ELIZABETH WALRAVEN
Credential	:	LCSW-S
Telephone Number	:	806-319-1864

Provider Enumeration Date	:	09/08/2023
Last Update Date	:	05/14/2025

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