Individual
COURTNEY REBEKAH LIETZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
827 W HARVARD ST, SILOAM SPRINGS, AR 72761-4013
(479) 549-3121
(479) 750-4843
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A1911163
AR
101YM0800X
Mental Health Counselor
Primary
P2306020
AR
171M00000X
Case Manager/Care Coordinator
—
OK
Other
Enumeration date
12/03/2017
Last updated
06/27/2023
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