Provider Demographics
NPI:1851938237
Name:NORDBY, CORRY TOMLINSON (LPC)
Entity Type:Individual
Prefix:
First Name:CORRY
Middle Name:TOMLINSON
Last Name:NORDBY
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 1:3663 N LAKEHARBOR LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-6913
Mailing Address - Country:US
Mailing Address - Phone:208-650-7359
Mailing Address - Fax:
Practice Address - Street 1:3663 N LAKEHARBOR LN
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-6913
Practice Address - Country:US
Practice Address - Phone:208-650-7359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-7361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health