Kjirsten Corson, LICDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LICDC.1614877 Issued in OH

Practice address

103 S Front St
Fremont, OH 43420-3021

Phone

(567) 280-4023

Fax

(567) 201-2669

NPI assigned

Jul 14, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1013439751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S FRONT ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S FRONT ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203021",
            "telephone_number": "567-280-4023",
            "fax_number": "567-201-2669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 E Main St",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "OH",
            "postal_code": "448571542",
            "country_code": "US",
            "telephone_number": "567-280-4023 x4304",
            "fax_number": "419-660-9848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1845 Superior St",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "448701825",
            "country_code": "US",
            "telephone_number": "419-502-1050",
            "fax_number": "419-502-1054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORSON",
        "first_name": "KJIRSTEN",
        "credential": "LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.1614877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Fremont, OH
• Providers in Fremont, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.