Basic Information
| Provider Information | |||||||||
| NPI: | 1053825794 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAGAHIS | ||||||||
| FirstName: | COURTNEY | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2450 HOLCOMBE BLVD STE NB-34L | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770212039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328283660 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6651 MAIN ST STE F350 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328265281 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2017 | ||||||||
| LastUpdateDate: | 11/16/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 59799 | TX | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.