Provider Demographics
NPI:1427276179
Name:LAZARUS, CORI MICHELLE (MA)
Entity type:Individual
Prefix:MS
First Name:CORI
Middle Name:MICHELLE
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:CORI
Other - Middle Name:MICHELLE
Other - Last Name:SEARCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:133 MAYFLOWER RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-9260
Mailing Address - Country:US
Mailing Address - Phone:423-283-6519
Mailing Address - Fax:423-283-6550
Practice Address - Street 1:3915 BRISTOL HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1400
Practice Address - Country:US
Practice Address - Phone:423-283-6519
Practice Address - Fax:423-283-6550
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor