MEDICARE: MARIAH DELAINEY CORDERY MA, LPC, CMHC

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
1	101YM0800X	Mental Health Counselor	11751015-6004	UT
2	101YP2500X	Professional Counselor	80090	TX

General Provider Information

NPI Number	:	1669090205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAH DELAINEY CORDERY MA, LPC, CMHC

Provider Business Mailing Address
First Line	:	4509 GREENHAM LN
Second Line	:
City	:	CROWLEY
State	:	TX
Zip	:	76036-3791
Country	:	US
Telephone Number	:	325-650-1431
Fax Number	:

Provider Business Practice Location Address
First Line	:	1508 SANTA FE DR STE 304
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5859
Country	:	US
Telephone Number	:	817-255-2652
Fax Number	:	817-255-2657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2020
Last Update Date	:	08/13/2025

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