Provider Demographics
NPI:1144610296
Name:CORNETT, LINDSEY NICOLE (LISW)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:NICOLE
Last Name:CORNETT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:NICOLE
Other - Last Name:HITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2725 PINKERTON LN
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1513
Mailing Address - Country:US
Mailing Address - Phone:740-487-3348
Mailing Address - Fax:
Practice Address - Street 1:2725 PINKERTON LN
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1513
Practice Address - Country:US
Practice Address - Phone:740-487-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI17002281041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0229475Medicaid