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NPI Code Detail

MEDICARE: JAMES CORNISH

MEDICARE: JAMES CORNISH
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
1104100000XSocial WorkerS.2504255-TRNEOH
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.193312OH

General Provider Information

NPI Number : 1639961923
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES CORNISH
Provider Business Mailing Address
First Line : 2005 ASHLAND AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43620-1703
Country : US
Telephone Number : 419-841-7701
Fax Number :
Provider Business Practice Location Address
First Line : 2005 ASHLAND AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43620-1703
Country : US
Telephone Number : 419-841-7701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2025
Last Update Date : 12/11/2025

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Directions to “ JAMES CORNISH ” Practice Location

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