Provider Demographics
NPI:1417935313
Name:CORLEY, GLYNDA BETH (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:GLYNDA
Middle Name:BETH
Last Name:CORLEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 TREVINO DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-8203
Mailing Address - Country:US
Mailing Address - Phone:512-517-5999
Mailing Address - Fax:512-388-9007
Practice Address - Street 1:307 N MAYS ST
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5135
Practice Address - Country:US
Practice Address - Phone:512-517-5999
Practice Address - Fax:512-388-9007
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12851101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional