Provider Demographics
NPI:1710086392
Name:LOUISE CORDING, PH.D., P.C.
Entity Type:Organization
Organization Name:LOUISE CORDING, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:G
Authorized Official - Last Name:CORDING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-371-0497
Mailing Address - Street 1:150 E PONCE DE LEON AVE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2543
Mailing Address - Country:US
Mailing Address - Phone:404-371-0497
Mailing Address - Fax:404-370-1800
Practice Address - Street 1:150 E PONCE DE LEON AVE
Practice Address - Street 2:SUITE 360
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2543
Practice Address - Country:US
Practice Address - Phone:404-371-0497
Practice Address - Fax:404-370-1800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA932103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBBHJMedicare ID - Type UnspecifiedMEDICARE PROVIDER