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Individual

COURTNEY LAINE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1513 E PRESIDIO ST STE B, FORT WORTH, TX 76102-6735
(817) 702-7345
(817) 702-2950
Mailing address
3821 ASHFORD AVE, FORT WORTH, TX 76133-2935
(608) 469-7336

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
62204
TX

Other

Enumeration date
04/02/2026
Last updated
04/02/2026
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