Healthcare Provider Details

I. General information

NPI: 1407739055
Provider Name (Legal Business Name): CORA STROUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6397 EMERALD PWKY SUITE 210
DUBLIN OH
43016
US

IV. Provider business mailing address

6397 EMERALD PWKY SUITE 210
DUBLIN OH
43016
US

V. Phone/Fax

Practice location:
  • Phone: 614-379-1490
  • Fax:
Mailing address:
  • Phone: 614-379-1490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.195613
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: