Provider Demographics
NPI:1366012551
Name:CORNELL & ASSOCIATES MARRIAGE AND FAMILY THERAPY
Entity type:Organization
Organization Name:CORNELL & ASSOCIATES MARRIAGE AND FAMILY THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:917-225-1401
Mailing Address - Street 1:41 UNION SQ W STE 1328
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3252
Mailing Address - Country:US
Mailing Address - Phone:917-225-1401
Mailing Address - Fax:
Practice Address - Street 1:41 UNION SQ W STE 1328
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3252
Practice Address - Country:US
Practice Address - Phone:917-225-1401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty