Individual
COURTNEY NICOLE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC, LCSW
Contact information
Practice address
805 ALEXA DR STE D, MT STERLING, KY 40353-1000
(859) 432-8002
(859) 432-8483
Mailing address
805 ALEXA DR STE D, MT STERLING, KY 40353-1000
(859) 432-8002
(859) 432-8483
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
246586
KY
1041C0700X
Clinical Social Worker
Primary
255310
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
11/20/2017
Last updated
12/10/2020
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