Provider Demographics
NPI:1326236779
Name:MEADER, CORINNE (LPC, LCAS)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:MEADER
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 BRANTLEY PLACE DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6859
Mailing Address - Country:US
Mailing Address - Phone:740-953-0173
Mailing Address - Fax:
Practice Address - Street 1:108 GATEWAY BLVD
Practice Address - Street 2:STE 207
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5596
Practice Address - Country:US
Practice Address - Phone:704-664-1175
Practice Address - Fax:704-664-1193
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6005932101YA0400X
NC6733101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health