Provider Demographics
NPI:1346323706
Name:CORN, BILLY WINFORD (LPC, LMFT, ADS)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:WINFORD
Last Name:CORN
Suffix:
Gender:M
Credentials:LPC, LMFT, ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8554 COUNTY ROAD 4023
Mailing Address - Street 2:
Mailing Address - City:KEMP
Mailing Address - State:TX
Mailing Address - Zip Code:75143-4354
Mailing Address - Country:US
Mailing Address - Phone:972-296-2676
Mailing Address - Fax:972-421-1816
Practice Address - Street 1:8554 COUNTY ROAD 4023
Practice Address - Street 2:
Practice Address - City:KEMP
Practice Address - State:TX
Practice Address - Zip Code:75143-4354
Practice Address - Country:US
Practice Address - Phone:972-296-2676
Practice Address - Fax:972-421-1816
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXICAADC 159101YA0400X
NONE101YP1600X
TX1343106H00000X
TX7220101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist