MEDICARE: EMILY ELIZABETH CORNELIUS MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1518825959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ELIZABETH CORNELIUS MSW

Provider Business Mailing Address
First Line	:	5025 OAK PARK CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5292
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5025 OAK PARK CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5292
Country	:	US
Telephone Number	:	863-944-7883
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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