Provider Demographics
NPI:1609105436
Name:TAGGART, CORI VAN CLEVE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CORI
Middle Name:VAN CLEVE
Last Name:TAGGART
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 E 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3212
Mailing Address - Country:US
Mailing Address - Phone:541-342-8255
Mailing Address - Fax:541-342-7987
Practice Address - Street 1:341 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3212
Practice Address - Country:US
Practice Address - Phone:541-342-8255
Practice Address - Fax:541-342-7987
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCO375101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health