Provider Demographics
NPI:1194582361
Name:CORDE, LYNDON (FOUNDER)
Entity type:Individual
Prefix:MR
First Name:LYNDON
Middle Name:
Last Name:CORDE
Suffix:
Gender:M
Credentials:FOUNDER
Other - Prefix:MR
Other - First Name:LYNDON
Other - Middle Name:
Other - Last Name:CORDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LYNDON CORDE
Mailing Address - Street 1:46 S JAMES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1621
Mailing Address - Country:US
Mailing Address - Phone:614-405-4476
Mailing Address - Fax:
Practice Address - Street 1:46 S JAMES RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1621
Practice Address - Country:US
Practice Address - Phone:614-405-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral