Provider Demographics
NPI:1023453453
Name:PALADINO, COURTNEY ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:PALADINO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:ELIZABETH
Other - Last Name:STACKPOOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:279 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-3364
Mailing Address - Country:US
Mailing Address - Phone:248-409-4165
Mailing Address - Fax:248-745-6872
Practice Address - Street 1:279 SUMMIT DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3364
Practice Address - Country:US
Practice Address - Phone:248-409-4165
Practice Address - Fax:248-745-6872
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010935271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical