Individual
COURTNEY COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3117 WHITING AVE, CHARLOTTE, NC 28205-1648
(919) 866-2273
Mailing address
3339 STOCKTIE RD, CHARLOTTE, NC 28210-6476
(919) 866-2273
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/19/2017
Last updated
09/14/2022
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