Provider Demographics
NPI:1417330994
Name:CORNELL RIORDAN, VICTORIA (LPCC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:CORNELL RIORDAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 BENT TREE DR APT 1A
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-6759
Mailing Address - Country:US
Mailing Address - Phone:513-444-8592
Mailing Address - Fax:
Practice Address - Street 1:935 N CASSADY AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2283
Practice Address - Country:US
Practice Address - Phone:614-202-9468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1800849101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional