Healthcare Provider Details

I. General information

NPI: 1659024370
Provider Name (Legal Business Name): CORI HEMMELGARN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4995 BRADENTON AVE STE 130
DUBLIN OH
43017-3551
US

IV. Provider business mailing address

4995 BRADENTON AVE STE 130
DUBLIN OH
43017-3551
US

V. Phone/Fax

Practice location:
  • Phone: 614-580-6917
  • Fax:
Mailing address:
  • Phone: 614-580-6917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2303473
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: