Provider Demographics
NPI:1225233265
Name:PASCOE, CORINNE PAULA (LPC, CEAP, CRC, NCC)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:PAULA
Last Name:PASCOE
Suffix:
Gender:F
Credentials:LPC, CEAP, CRC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 ARIZONA AVE NE
Mailing Address - Street 2:STE #159
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2248
Mailing Address - Country:US
Mailing Address - Phone:678-571-1832
Mailing Address - Fax:
Practice Address - Street 1:195 ARIZONA AVE NE
Practice Address - Street 2:STE #159
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-2248
Practice Address - Country:US
Practice Address - Phone:678-571-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCEAP0038067101Y00000X
GACRC00050106101YM0800X
GALPC004286101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional