DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: CORY S DIVINE CSAC, LPC

MEDICARE: CORY S DIVINE CSAC, LPC
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
1101YP2500XProfessional Counselor6901-125WI
2101YA0400XAddiction (Substance Use Disorder) Counselor15367-132WI

General Provider Information

NPI Number : 1558494211
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORY S DIVINE CSAC, LPC
Provider Business Mailing Address
First Line : 6402 ODANA RD STE 106
Second Line :
City : MADISON
State : WI
Zip : 53719-1123
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6402 ODANA RD STE 106
Second Line :
City : MADISON
State : WI
Zip : 53719-1123
Country : US
Telephone Number : 608-220-8627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 01/02/2025

Similar Medicare Providers

1124084884 — DR. JACKIE LEE SPLITTER PH.D.
Practice Location Address:
6402 ODANA RD
MADISON, WI
53719-1123
Practice Phone: 608-273-4411
Practice Fax:
1841370384 — SONAS BEHAVIORAL HEALTH LLC
Practice Location Address:
6402 ODANA RD
MADISON, WI
53719-1123
Practice Phone: 608-204-6076
Practice Fax: 608-204-9568
1639299589 — AMY FILLEY GUINTHER L.AC.
Practice Location Address:
6402 ODANA RD
MADISON, WI
53719-1123
Practice Phone: 608-556-9313
Practice Fax:
1033305081 — JANICE SINGLES, PSYD, LLC
Practice Location Address:
6402 ODANA RD , BIRCH SPRINGS
MADISON, WI
53719-1123
Practice Phone: 608-273-4411
Practice Fax:
1902088933 — MS. CINDA LOU LAMAR MS, LCSW
Practice Location Address:
6402 ODANA RD
MADISON, WI
53719-1123
Practice Phone: 608-273-4411
Practice Fax:
1023283397 — CHAMELEON GROUP
Practice Location Address:
6402 ODANA RD
MADISON, WI
53719-1123
Practice Phone: 608-288-9040
Practice Fax: 608-288-9042

Directions to “ CORY S DIVINE CSAC, LPC” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.