Provider Demographics
NPI:1568502763
Name:CORDER, PATRICIA S (LPCC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:CORDER
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 1:68353 BANNOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9736
Mailing Address - Country:US
Mailing Address - Phone:740-695-9344
Mailing Address - Fax:740-695-7787
Practice Address - Street 1:68353 BANNOCK RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9736
Practice Address - Country:US
Practice Address - Phone:740-695-9344
Practice Address - Fax:740-695-7787
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000217372OtherANTHEM BCBS
OH275587000OtherMAGELLAN BEHAVIORAL HEALT
WV001715731OtherMOUNTAIN STATE BCBS
NY469443OtherVALUE OPTIONS