Provider Demographics
NPI:1922283563
Name:CORDES, MEGAN MARIE (LSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:CORDES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18779 COUNTY ROAD R1
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-9599
Mailing Address - Country:US
Mailing Address - Phone:419-267-5264
Mailing Address - Fax:
Practice Address - Street 1:1 STRANAHAN SQ
Practice Address - Street 2:SUITE 414
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1447
Practice Address - Country:US
Practice Address - Phone:419-288-5511
Practice Address - Fax:419-321-6459
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS 0600319101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health