Provider Demographics
NPI:1831716885
Name:ORMAND, CORIE SINEA
Entity type:Individual
Prefix:MRS
First Name:CORIE
Middle Name:SINEA
Last Name:ORMAND
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CORIE
Other - Middle Name:SINEA
Other - Last Name:RUNNELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1185
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-1185
Mailing Address - Country:US
Mailing Address - Phone:575-538-1895
Mailing Address - Fax:575-523-2299
Practice Address - Street 1:301 W COLLEGE AVE
Practice Address - Street 2:SUITE 17
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061
Practice Address - Country:US
Practice Address - Phone:575-538-1895
Practice Address - Fax:575-523-2299
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM42332362Medicaid