Antoinette S Cordell, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1835 Issued in OH

Practice address

342 Allen St
Yellow Springs, OH 45387-1306

Phone

(937) 776-2836

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1265581524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 ALLEN ST",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871306",
            "telephone_number": "937-776-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 ALLEN ST",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871306",
            "telephone_number": "937-776-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDELL",
        "first_name": "ANTOINETTE",
        "middle_name": "S",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "1835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0356065",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Lee Collins-Stratton, PT
• Community Birth Group
• Community Physicians of Yellow Springs, Inc.
• Jeffrey Lane Conrad, LPC
• Gerald P Copas, LPCC
• Suzanne Therese Croteau, D.O.
• Noah Michael Davis-Cheshire
• David J Day, LPN
• Deanna Markesteyn Counseling
• Sharon Dibiase, SWT

• Clinical Psychologist in Yellow Springs, OH
• Providers in Yellow Springs, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.