Provider Demographics
NPI:1427318351
Name:CORNUE, MARLEE ELIZABETH (LPCC)
Entity type:Individual
Prefix:
First Name:MARLEE
Middle Name:ELIZABETH
Last Name:CORNUE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 PIMLICO PL
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-3953
Mailing Address - Country:US
Mailing Address - Phone:315-345-9154
Mailing Address - Fax:
Practice Address - Street 1:2831 CAMINO DEL RIO S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3802
Practice Address - Country:US
Practice Address - Phone:619-693-7527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16347101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health