Provider Demographics
NPI:1689083131
Name:MUIR, COURTNEY (MA, LMFT 97006)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:
Last Name:MUIR
Suffix:
Gender:F
Credentials:MA, LMFT 97006
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6824 HYDE PARK DR UNIT H
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-2295
Mailing Address - Country:US
Mailing Address - Phone:909-702-9030
Mailing Address - Fax:
Practice Address - Street 1:6824 HYDE PARK DR UNIT H
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-2295
Practice Address - Country:US
Practice Address - Phone:909-702-9030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 97006106H00000X
CAIMF79377106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist