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Courtney L Hirsch

Counselor

Behavioral Health & Social Service Providers

1101 Cumberland Xing # 108, Valparaiso, IN 46383-2356

(866) 413-1988 (219) 313-0568

PECOS Enrollment

Based on the most recent information from CMS, provider Courtney L Hirsch does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:05 AM.

Profile Details

Provider ID
1396469615
Provider Type
Individual
Full Name
Hirsch, Courtney L
Gender
Female

Sole Proprietor
No
Enumeration Date
9/29/2022
Last Updated
9/29/2022

Contact Information

Practice Location

1101 Cumberland Xing # 108, Valparaiso, IN 46383-2356

(866) 413-1988

(866) 628-8599

Mailing Location

24257 S Timberline Trl, Crete, IL 60417-2728

(219) 313-0568

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 103K00000X	Description Behavior Analyst Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 106S00000X	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer

Courtney L Hirsch

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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