COURTNEY WILLIS (NPI# 1073013298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073013298 |
| Entity Type | Individual |
| Full Name | COURTNEY WILLIS |
| Practice Address |
455 Winn Way Decatur GA 30030-1707 |
| Mailing Address |
445 Winn Way Decatur GA 30030-1707 |
| Practice Telephone | 4042943745 |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2018-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | APC006249 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699330282 | Courtney S Willis | Nurse Practitioner | 2203 N Greenwood Dr, Johnson City, TN 37604-7030 | 2019-05-08 |
| 1083019921 | Courtney Willis | Speech-Language Pathologist | 3130 N Shiloh Rd, Garland, TX 75044-8014 | 2014-11-04 |
| 1326508490 | Courtney Willis | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave Dept Of, Albany, NY 12208-3412 | 2019-03-23 |
| Street Address |
455 WINN WAY |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-1707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356360150 | Melanie C Fisher | Clinical Nurse Specialist | 455 Winn Way, Dekalb Crisis Center, Decatur, GA 30030 | 2006-07-19 |
| 1043666878 | Donna Jarrett | Registered Nurse | 455 Winn Way, Decatur, GA 30030-1707 | 2016-05-11 |
| 1740634187 | Lucille Henderson-weaver | Registered Nurse | 455 Winn Way, Decatur, GA 30030-1707 | 2016-04-22 |
| 1295189637 | Marie Faustin | Registered Nurse | 455 Winn Way, Decatur, GA 30030-1707 | 2016-04-22 |
| 1558715995 | Angela Holder | Registered Nurse | 455 Winn Way, Decatur, GA 30030-1707 | 2016-04-22 |
| 1861846107 | Denise Gonzalez | Registered Nurse | 455 Winn Way, Decatur, GA 30030 | 2016-04-22 |
| 1700230141 | Tanya Nicholas | Registered Nurse | 455 Winn Way, Decatur, GA 30030-1707 | 2016-04-22 |
| 1457705899 | Linda Jones | Registered Nurse | 455 Winn Way, Decatur, GA 30030-1707 | 2016-04-22 |
| 1134573579 | Natasha Tyson | Registered Nurse | 455 Winn Way, Decatur, GA 30030-1707 | 2016-04-22 |
| 1033563473 | Robin Williams | Registered Nurse | 455 Winn Way, Decatur, GA 30030-1707 | 2016-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285244293 | Agape Change Family Counseling & Consultation Services LLC | Counselor | 2128 Willamette Way, Decatur, GA 30032-6036 | 2020-08-04 |
| 1366082356 | Morgan Tudor | Counselor | 433 W Pershing Rd, Decatur, IL 62526-3238 | 2020-01-08 |
| 1083171896 | William Dale Cottrell II | Counselor | 315 W Ponce De Leon Ave Ste 1055, Decatur, GA 30030-2412 | 2019-02-28 |
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1528538048 | Beatrice Irma Richie | Counselor | 117glen Hollow Circle Apartment #4, Decatur, GA 30034-3003 | 2018-11-27 |
| 1912473711 | Kameshia Hawkins | Counselor | 3011 Rainbow Dr Ste B, Decatur, GA 30034-1643 | 2018-10-18 |
| 1467942706 | Marla Singleton | Counselor | 235 E Ponce De Leon Ave Ste 108, Decatur, GA 30030-3412 | 2018-05-11 |
| 1306348321 | Maureen P Nolan | Counselor | 315 W Ponce De Leon Ave Ste 540, Decatur, GA 30030-2448 | 2018-03-06 |
| 1619493806 | Camille Hankins | Counselor | 2545 Lawrenceville Hwy Ste 150, Decatur, GA 30033-3240 | 2017-08-18 |
| 1609390319 | Subrena Ann Glenn | Counselor | 3745 Brookside Pkwy, Decatur, GA 30034-5714 | 2017-08-03 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.