Provider Demographics
NPI:1659878601
Name:CORNELL, ALLISON M (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:M
Last Name:CORNELL
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 ELIKA CT
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3263
Mailing Address - Country:US
Mailing Address - Phone:254-749-0483
Mailing Address - Fax:
Practice Address - Street 1:3535 FIREWHEEL DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2628
Practice Address - Country:US
Practice Address - Phone:254-749-0483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71371101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX$$$$$$$$$Medicaid