Provider Demographics
NPI:1740299338
Name:CORDER, DIANA D'ALBERGO I (LPC)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:D'ALBERGO
Last Name:CORDER
Suffix:I
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:PO BOX 1094
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-1094
Mailing Address - Country:US
Mailing Address - Phone:281-424-7732
Mailing Address - Fax:832-556-8656
Practice Address - Street 1:600 WARD RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-4861
Practice Address - Country:US
Practice Address - Phone:281-360-5279
Practice Address - Fax:832-556-8656
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11307101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLP0008488Medicaid