Provider Demographics
NPI:1891938791
Name:CORDIS COUNSELING
Entity Type:Organization
Organization Name:CORDIS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:401-663-9534
Mailing Address - Street 1:750 EAST AVENUE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6165
Mailing Address - Country:US
Mailing Address - Phone:401-663-9534
Mailing Address - Fax:
Practice Address - Street 1:750 EAST AVENUE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6165
Practice Address - Country:US
Practice Address - Phone:401-663-9534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMFT00118106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty