Individual
MRS. COURTNEY ROSE THREATS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, AADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CPD00969
RI
101YM0800X
Mental Health Counselor
CSW01753
RI
1041C0700X
Clinical Social Worker
Primary
ISW04025
RI
Other
Enumeration date
12/12/2022
Last updated
01/31/2024
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