Individual
COURTNEY DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LICDC
Contact information
Practice address
3409 E BROAD ST, COLUMBUS, OH 43213-1064
(380) 201-1101
Mailing address
4214 E MAIN ST, WHITEHALL, OH 43213-3028
(614) 334-6903
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161741
OH
101YM0800X
Mental Health Counselor
Primary
E.2203162
OH
Other
Enumeration date
09/28/2020
Last updated
05/04/2024
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