Provider Demographics
NPI:1427760081
Name:AVERAINO, CORI LEE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CORI
Middle Name:LEE
Last Name:AVERAINO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 CAMPUS DR APT 7
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2246
Mailing Address - Country:US
Mailing Address - Phone:520-456-4906
Mailing Address - Fax:
Practice Address - Street 1:4500 CAMPUS DR APT 7
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2246
Practice Address - Country:US
Practice Address - Phone:520-456-4906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-7469T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker