Provider Demographics
NPI:1528692928
Name:COR COUNSELING LLC
Entity type:Organization
Organization Name:COR COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:O'HERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-802-1237
Mailing Address - Street 1:612 E COLONIAL DR STE 390
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4650
Mailing Address - Country:US
Mailing Address - Phone:321-802-1237
Mailing Address - Fax:
Practice Address - Street 1:612 E COLONIAL DR STE 390
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4650
Practice Address - Country:US
Practice Address - Phone:321-802-1237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health