Provider Demographics
NPI:1255063210
Name:SHELLEY CORDES COUNSELING, INC
Entity type:Organization
Organization Name:SHELLEY CORDES COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDES
Authorized Official - Suffix:
Authorized Official - Credentials:LMC
Authorized Official - Phone:989-884-1280
Mailing Address - Street 1:19314 NE 172ND ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-9451
Mailing Address - Country:US
Mailing Address - Phone:989-884-1280
Mailing Address - Fax:
Practice Address - Street 1:19314 NE 172ND ST
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-9451
Practice Address - Country:US
Practice Address - Phone:989-884-1280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty