Provider Demographics
NPI:1154960151
Name:CORY, ALISON LYNNE (PHD, LPC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LYNNE
Last Name:CORY
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:LYNNE
Other - Last Name:CORY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:134 GRAND OAK CIR
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-1647
Mailing Address - Country:US
Mailing Address - Phone:770-855-8852
Mailing Address - Fax:
Practice Address - Street 1:134 GRAND OAK CIR
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:SC
Practice Address - Zip Code:29670-1647
Practice Address - Country:US
Practice Address - Phone:770-855-8852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional