Healthcare Provider Details

I. General information

NPI: 1932036001
Provider Name (Legal Business Name): ELIZABETH CHORDAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LIZZIE CHORDAS

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 MCKINLEY AVE APT 405
COLUMBUS OH
43204-3976
US

IV. Provider business mailing address

3255 MCKINLEY AVE APT 405
COLUMBUS OH
43204-3976
US

V. Phone/Fax

Practice location:
  • Phone: 330-978-4501
  • Fax:
Mailing address:
  • Phone: 330-978-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberI.2506262-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: